氟比洛芬酯复合舒芬太尼镇痛对骨科患者术后谵妄发生率的影响

目的 观察氟比洛芬酯复合舒芬太尼镇痛对骨科患者术后谵妄发生率的影响.方法 拟行择期骨科手术患者370例,年龄≥60岁,随机均分为氟比洛芬酯复合舒芬太尼组(FS组)和脂肪乳复合舒芬太尼组(S组),术后连续3d行PCIA,并随访谵妄的发生(CAM-ICU法)、VAS评分和舒芬太尼使用量.结果 FS组术后谵妄发生率明显低于S组(16.3％ vs.26.2％,RR=0.62,95％ CI 0.41～0.93) (P＜0.05).FS组罹患谵妄的风险是S组的0.57倍(95％ CI 0.34～0.96)(P＜0.05).FS组术后VAS评分及舒芬太尼用量均明显低于S组(P＜0.01).结论 与单纯应用舒芬太尼相比,氟比洛芬酯复合舒芬太尼镇痛能够减少骨科患者术后谵妄的发生率.

Effects of flurbiprofen axetil combined with sufentanil analgesia on the incidence of postoperative delirium in orthopedic patients

Objective To investigate the efficacy of flurbiprofen axetil combined with sufentanil analgesia on prevent postoperative delirium in orthopedic patients.Methods Three hundred and seventy patients who were aged 60 years or older and underwent elective orthopedic surgery were randomized into flurbiprofen axetil plus sufentanil group (group FS) or fat emulsion plus sufentanil group(group S). After surgery, patients were given 3 days PCIA according two groups. The presence of delirium, the visual analog scale (VAS) and the consumptions of sufentanil were recorded.Results The incidence of delirium was significantly lower in the group FS than that in the group S (16.3% versus 26.2%, RR=0.62, 95% CI 0.41-0.93) (P<0.05). The point prevalence of delirium in the group FS was also lower compared with group S, and the risk of suffering delirium for group FS was 0.57 times as great as that for group S (95% CI 0.34-0.96) (P<0.05). The VAS scores were significantly low, the sufentanil consumptions were remarkably less in group FS than in group S.Conclusion Compare sufentanil group, group FS postoperative analgesia significantly reduce the incidence and the prevalence of delirium in orthopedic patients.