艾司氯胺酮联合布托啡诺对老年病人全髋关节置换术后镇痛效果及早期康复的影响
Effect of esketamine combined with butorphanol on analgesic effect and early rehabilitation in elderly patients after total hip arthroplas-ty
曹蕾 1刘猛 1王额尔敦1
作者信息
- 1. 中国人民解放军海军第971医院麻醉科,山东 青岛 266071
- 折叠
摘要
目的 探讨艾司氯胺酮联合布托啡诺用于老年全髋关节置换术后病人静脉自控镇痛(PCIA)的效果和对早期康复的影响.方法 选择2022年1月-2023年3月于我院在腰硬联合麻醉下行全髋关节置换术的老年病人85例.随机将病人分为试验组和对照组,其中对照组42例,单纯应用布托啡诺0.15 mg/kg行术后PCIA;试验组43例,联合应用布托啡诺0.10 mg/kg和艾司氯胺酮100 mg行术后PCIA.记录两组病人术后6、24、48 h的疼痛视觉模拟评分法(VAS)评分和Ramsay镇静评分;术后24、48 h采用15项恢复质量量表(QoR-15)评价病人早期康复情况;记录术后不良反应的发生情况.结果 试验组病人术后6、24、48 h的VAS评分和Ramsay镇静评分均低于对照组(Z=2.167～5.845,P＜0.05),术后 24、48 h 的 QoR-15 评分高于对照组(Z=3.773、6.085,P＜0.05).两组不良反应的总发生率无统计学差异(P＞0.05).结论 艾司氯胺酮联合布托啡诺用于术后PCIA能有效提高老年病人全髋关节置换术后的镇痛效果,改善术后镇静水平,促进病人术后早期康复.
Abstract
Objective To investigatethe effect of esketamine combined with butorphanol on patient-controlled intravenous analgesia(PCIA)and early rehabilitationin elderly patients aftertotal hiparthroplasty.Methods A total of 85 elderly patients who underwent total hip arthroplasty under combined spinal-epidural anesthesia in our hospital from January 2022 to March 2023 were enrolled and randomly divided into experimental group with 43 patients and control group with 42 patients.The patients in the control group received butorphanol 0.15 mg/kg alone for postoperative PCIA,and those in the experimental group received butor-phanol 0.10 mg/kg combined with esketamine 100 mg for postoperative PCIA.The Visual Analogue Scale(VAS)score for pain and Ramsay sedation score were recorded at 6,24,and 48 h after surgery;the 15-item Quality of Recovery(QoR-15)scale was used to evaluate the status of early recovery at 24 and 48 h after surgery;postoperative adverse reactions were also recorded.Results Compared with the control group,the observation group had significantly lower VAS score and Ramsay sedation score at 6,24,and 48 h after surgery(Z=2.167-5.845,P＜0.05)and a significantly higher QoR-15 score at 24 and 48 h after surgery(Z=3.773,6.085,P＜0.05).There was no significant difference in the overallincidence rate of adverse reactions between the two groups(P＞0.05).Conclusion The combination of esketamine and butorphanol for postoperative PCIA can effectively improve analgesic effect and sedation level after surgery and promote early postoperative recovery in elderly patients undergoing total hip ar-throplasty.
关键词
氯胺酮/布托啡诺/疼痛,手术后/镇痛,病人控制/康复Key words
ketamine/butorphanol/pain,postoperative/analgesia,patient-controlled/rehabilitation引用本文复制引用
基金项目
山东省自然科学基金(ZR2020QH356)
军队卫勤保障能力创新与生成专项(21WQ019)
出版年
2024
国家科技期刊平台
NSTL
万方数据