RESUMEN
Objective To evaluate the analgesic effect of a new combined analgesic mode in the early stage of non-opera-tive treatment of adult traumatic rib fractures. Methods A total of 93 patients with rib fractures who did not receive surgical treatment from January 2014 to January 2018 were prospectively included, and randomly divided into the traditional analgesia group, subcutaneous analgesia group and combined analgesia group(31 cases each). There were 56 males and 37 females total-ly with a median age of(47.3 ±13.2)years. All patients have moderate to severe pain with VAS scores greater than 5. Tradi-tional analgesia group: lornoxicam 8 mg intravenous injection twice daily. Subcutaneous analgesia group: only subcutaneous self-controlled analgesia pump was used for treatment. Combined analgesia group: on the basis of the traditional analgesia group, subcutaneous self-controlled analgesia pump was added for treatment, and the dosage of the pump drug was the same as that of subcutaneous analgesia group. The VAS scores at tranquillization and cough were compared before analgesia treatment (T1), 24 h(T2), 48 h(T3) and 72 h(T4) after analgesic treatment in each group during bed brake within 3 days after inju-ry. The VAS scores after 78 hours of analgesic treatment during ambulation were compared. When sudden pain with VAS score greater than 7 occurred within 72 hours of bed staying treatment in each group, the average daily use times of bucinnazine hydrochloride 100mg remedial analgesia were compared. The number of adverse reactions such as nausea and pneumonia in each group was compared. Results The VAS scores of resting pain and cough pain at the observation time point(T2-T4) in the combined analgesia group were better than those in the subcutaneous analgesia group and the traditional analgesia group, showing a significant difference(P<0. 05). When getting out of bed, there were significant differences in pain scores among the three groups, and the pain score of the combined analgesia group was the lowest. There was a significant difference among the three groups in the number of daily additions of bucinnazine hydrochloride during remedial analgesia(P<0. 05),the com-bined analgesia group was the least. Between the two groups of patients using analgesic pump, the number of self-compressions in the combined analgesia group was lower than that in the subcutaneous analgesia group(P<0. 05). The incidence of pneumo-nia in the combined analgesia group was lower than that in the other two groups and the incidence of other adverse reactions such as nausea was lower than that in the simple analgesia group. Conclusion In the early stage of non-operative treatment of traumatic rib fractures in adults, the multi-mode analgesic effect of traditional intravenous intermittent administration combined with subcutaneous continuous administration is superior to the single analgesic mode of traditional intravenous or subcutaneous administration with no obvious adverse reactions.
RESUMEN
Objective@#To evaluate the analgesic effect of a new combined analgesic mode in the early stage of non-operative treatment of adult traumatic rib fractures.@*Methods@#A total of 93 patients with rib fractures who did not receive surgical treatment from January 2014 to January 2018 were prospectively included, and randomly divided into the traditional analgesia group, subcutaneous analgesia group and combined analgesia group(31 cases each). There were 56 males and 37 females totally with a median age of(47.3±13.2)years. All patients have moderate to severe pain with VAS scores greater than 5. Traditional analgesia group: lornoxicam 8 mg intravenous injection twice daily. Subcutaneous analgesia group: only subcutaneous self-controlled analgesia pump was used for treatment. Combined analgesia group: on the basis of the traditional analgesia group, subcutaneous self-controlled analgesia pump was added for treatment, and the dosage of the pump drug was the same as that of subcutaneous analgesia group. The VAS scores at tranquillization and cough were compared before analgesia treatment(T1), 24 h(T2), 48 h(T3) and 72 h(T4) after analgesic treatment in each group during bed brake within 3 days after injury. The VAS scores after 78 hours of analgesic treatment during ambulation were compared. When sudden pain with VAS score greater than 7 occurred within 72 hours of bed staying treatment in each group, the average daily use times of bucinnazine hydrochloride 100mg remedial analgesia were compared. The number of adverse reactions such as nausea and pneumonia in each group was compared.@*Results@#The VAS scores of resting pain and cough pain at the observation time point(T2-T4) in the combined analgesia group were better than those in the subcutaneous analgesia group and the traditional analgesia group, showing a significant difference(P<0.05). When getting out of bed, there were significant differences in pain scores among the three groups, and the pain score of the combined analgesia group was the lowest. There was a significant difference among the three groups in the number of daily additions of bucinnazine hydrochloride during remedial analgesia(P<0.05), the combined analgesia group was the least. Between the two groups of patients using analgesic pump, the number of self-compressions in the combined analgesia group was lower than that in the subcutaneous analgesia group(P<0.05). The incidence of pneumonia in the combined analgesia group was lower than that in the other two groups and the incidence of other adverse reactions such as nausea was lower than that in the simple analgesia group.@*Conclusion@#In the early stage of non-operative treatment of traumatic rib fractures in adults, the multi-mode analgesic effect of traditional intravenous intermittent administration combined with subcutaneous continuous administration is superior to the single analgesic mode of traditional intravenous or subcutaneous administration with no obvious adverse reactions.
RESUMEN
Objective To investigate the effect of patient controlled subcutaneous analgesia (PCSA) of Sufentamil and Parecoxib sodium on the postoperative delirium in patients after the spinal surgery. Methods 240 patients with ASA Ⅱ- Ⅲ age 18-64 yrs after the spinal surgery were divided into two groups: group NO-PCSA (analgesic management: patients were accepted pethidine 25-50 mg intramuscular injection n = 120 );group PCSA (analgesic management: patient controlled subcutaneous analgesia was started since skin suture with the following composition:Sufentanil 0.9 ug/(kg.d)+Parecoxib sodium 120 mg+Tropisetron 10 mg+normal saline 150 mL. The PCSA setting was as follows:background infusion at 2 mL/h, a bolus dose of 0.5 mL, lockout interval 15 min. If the VAS was greater than 5, patient was accepted pethidine 25-50 mg intramuscular injection n=120) . The effect of analgesia was assessed by visual analogue scale (VAS) . The delirium was assessed by the confusion assessment, VAS and delirium were recorded with in 2, 24, 48, 72 hours postoperatively. Results During the analgesia period, the VAS and the incidence of postoperative delirium were significantly lower in group PCSA than those in group NO-PCSA ( <0.05) . Conclusion PCSA of Sufentamil and Parecoxib sodium have a good postoperative analgesic effect in patients after the spinal surgery. It is an effective measure and the incidence of postoperative delirium can be decreased by reliefing postoperative pain.
RESUMEN
ObjectiveTo investigate the effects of controlled subcutaneous analgesia(PCSA) with sufentanil in patients underwent abdominal surgery and the occurrence of adverse reactions. Methods90 patients underwent abdominal surgery were randomly divided intothree groups with 30 cases each. Group Ⅰ :sufentanil 0. 04μg · kg-1 ·h-1 for postoperative analgesia; Group Ⅱ : sufentanil 0. 06μg · kg-1 · h-1 for postoperative analgesia; Group Ⅲ :sufentanil 0.08μg/kg · h for postoperative analgesia;PCSA started at the end of operation with catheter buried in deltoid muscle. Visual analgesia scale(VAS) ,Rasmay scale and side effects were recorded at 4,8,16,24 and 48h after operation. ResultsVAS scores decreased significantly in group Ⅱ and group Ⅲ compared with that in group Ⅰ ( all P ＜ 0.05) ;There were no differences of Ramsay scores between groups ( all P ＞ 0. 05) ;There were three cases of respiratory depression in group Ⅲ. ConclusionPCSA with sufentanil (0.06μg/kg) had exact analgesic effects for postoperative abdominal surgery patients with less adverse reactions.