通讯作者: 李云伟, liyunwei2022@163.com

DOI：10.12201/bmr.202501.00024

The Value of Intravenous Paracetamol Combined with Nerve Block in Preoperative Analgesia for Elderly Patients with Hip Fracture

• 摘要：摘要 目的 评价术前静脉注射对乙酰氨基酚的安全性和有效性，探讨静脉注射对乙酰氨基酚联合神经阻滞在老年髋部骨折术前镇痛中的效果及对临床预后的影响。方法 选取我院2023年12月-2024年8月骨科收治的老年髋部骨折患者80例为研究对象，均使用0.25%罗哌卡因20ml进行髋关节囊周神经阻滞(Pericapsular Nerve Group Block，PENG阻滞)，而后随机分为静脉对乙酰氨基酚组和口服对乙酰氨基酚组，每 6h 给予对乙酰氨基酚一次，每次500mg，共4 次，比较两组镇痛效果、不良反应和短期预后的指标。 结果 静脉对乙酰氨基酚组疼痛缓解时间（10.05±2.89）较口服组（23.63±8.10）更短，静脉组补救镇痛次数少，阿片类药物使用量低分别为0.60±1.45和1.80±2.21，（p<0.05）。两组不良反应发生率以及住院时间和好转出院率等短期预后指标差异无统计学意义（p>0.05）。 结论 静脉注射对乙酰氨基酚联合神经阻滞可安全有效地用于老年髋部骨折患者的术前镇痛。

  关键词： 对乙酰氨基酚、老年髋部骨折、术前镇痛

   

  Abstract: 【Abstract】 Objective To evaluate the safety and efficacy of preoperative intravenous paracetamol, and to investigate the effect and influence on clinical prognosis of intravenous paracetamol combined with nerve block for preoperative analgesia in elderly patients with hip fracture. Methods Eighty elderly patients with hip fracture admitted to our hospital from December 2023 to August 2024 were selected as the research subjects, all patients were treated with 0.25% ropivacaine 20ml for pericapsular nerve group block(PENG block), and then they were randomly divided into intravenous paracetamol group and oral paracetamol group, acetaminophen was given once every 6h, 500mg each time, a total of 4 times, analgesic effects, adverse reactions, and short-term prognostic indicators were compared between the two groups. Results The pain relief time in the intravenous paracetamol group (10.05±2.89) was shorter than that in the oral group (23.63±8.10), and the rescue analgesic doses were fewer and the use of opioid drugs was lower in the intravenous group (0.60±1.45 and 1.80±2.21, respectively), (p<0.05). There were no significant differences in the incidence of adverse reactions, short-term prognostic indicators such as duration of hospital stay and improved discharge rate between the two groups (p>0.05). Conclusions Intravenous paracetamol combined with nerve block can be safely and effectively used for preoperative analgesia in elderly patients with hip fracture.

  Key words: Paracetamol, Elderly Hip Fracture, Preoperative Analgesia

  提交时间：2025-01-08

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2024-11-06	bmr.202501.00024V1	下载

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