多模式镇痛在胸腰椎骨折患者围手术期的应用及效果分析
Application and effect analysis of multimodal analgesia in perioperative period of patients with thoracolumbar fracture
陈少初 1林丽珊 2余丽萍 3张昊 1龚铭1
作者信息
- 1. 深圳市龙华区人民医院脊柱外科,广东深圳 518109
- 2. 深圳市龙华区人民医院医患关系科,广东深圳 518109
- 3. 深圳市龙华区人民医院手术室,广东深圳 518109
- 折叠
摘要
目的 探讨多模式镇痛在胸腰椎骨折患者围手术期的应用效果,为胸腰椎骨折患者围手术期镇痛提供一种可靠的方式.方法 选取2020年10月～2023年8月于我院行手术治疗的胸腰椎骨折患者50例,随机分为对照组(n=25)及多模式镇痛组(n=25),患者按各组内用药方案给予镇痛治疗,比较两组手术前后的视觉模拟评分法(VAS)评分、C反应蛋白(CRP)水平、白细胞介素-6(IL-6)水平、平均住院时间、不良反应发生情况、阿片类药物使用情况.结果 多模式镇痛组术后1 d、术后3 d、术后7 d的VAS评分明显低于对照组,差异有统计学意义(P＜0.05).两组患者术后1 d的血清CRP、IL-6水平均上升,多模式镇痛组低于对照组,差异有统计学意义(P＜0.05);术后3 d两组的血清CRP、IL-6水平均下降,多模式镇痛组低于对照组,差异有统计学意义(P＜0.05).多模式镇痛组平均住院时间显著少于对照组(P＜0.05).两组不良反应发生情况比较,差异无统计学意义(P＞0.05);多模式镇痛组曲马多的平均使用剂量少于对照组,差异有统计学意义(P＜0.05).结论 多模式镇痛可减轻胸腰椎骨折患者术后的疼痛程度,缩短平均住院时间.
Abstract
Objective To explore the application effect of multimodal analgesia in perioperative period of patients with thoracolumbar fractures,and to provide a reliable way for perioperative analgesia in patients with thoracolumbar fractures.Methods 50 patients with thoracolumbar fractures who underwent surgical treatment in our hospital from October 2020 to August 2023 were randomly divided into control group(n=25)and multimodal analgesia group(n=25).The patients were given analgesic treatment according to the medication regimen in each group.The visual analogue scale(VAS)score,C-reactive protein(CRP)level,interleukin-6(IL-6)level,average hospitalization time,adverse reactions,and opioid use before and after surgery were compared between the two groups.Results The VAS scores of the multimodal analgesia group at 1 d,3 d and 7 d after operation were significantly lower than those of the control group,and the differences were statistically significant(P<0.05).The levels of serum CRP and IL-6 of the two groups increased at 1 d after operation,and the levels of the multimodal analgesia group were lower than those in the control group,the differences were statistically significant(P<0.05).The levels of serum CRP and IL-6 decreased at 3 d after operation,and the levels of the multimodal analgesia group were lower than those in the control group,the differences were statistically significant(P<0.05).The average hospitalization time of the multimodal analgesia group was significantly shorter than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The average dose of tramadol in the multimodal analgesia group was less than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Multimodal analgesia can reduce postoperative pain and shorten the average hospital stay in patients with thoracolumbar fractures.
关键词
多模式镇痛/胸腰椎骨折/围手术期/罗哌卡因/氟比洛芬酯/术后疼痛Key words
Multimodal analgesia/Thoracolumbar fracture/Perioperative period/Ropivacaine/Flurbiprofen axetil/Postoperative pain引用本文复制引用
基金项目
深圳市龙华区医疗卫生机构区级科研项目(2020082)
出版年
2024
NETL
NSTL
万方数据