局解手术学杂志2025，Vol.34Issue(6)：540-543,4.DOI:10.11659/jjssx.07E024084
体质量指数对老年股骨近端防旋髓内钉手术后舒芬太尼镇痛效果的影响
Influence of body mass index on the analgesic effect of sufentanil in elderly patients after proximal femoral nail anti-rotation surgery
摘要
Abstract
Objective To investigate the influence of body mass index(BMI)on individualized analgesic effect,inflammatory factors and safety of sufentanil in elderly patients after proximal femoral nail anti-rotation(PFNA)surgery.Methods A total of 161 elderly patients who received PFNA surgery in Nanjing Drum Tower Hospital Group Suqian Hospital from January 2022 to December 2023 were selected as study subjects.Patients with BMI<18.5 kg/m2 were set as Group A,patients with BMI ranging from 18.5 kg/m2 to 23.9 kg/m2 were set as Group B,patients with BMI ranging from 24.0 kg/m2 to 35.0 kg/m2 were set as Group C.After operation,individualized analgesia was performed with an intravenous patient-controlled analgesia pump of 2 μg/kg sufentanil based on body weight,and the postoperative pain degree,inflammatory factors,analgesia condition and adverse reactions of patients in the three groups were compared.Results At 8 hours,12 hours,24 hours and 48 hours after surgery,the pain visual analogue scale(VAS)scores of patietns in group B and group C were significantly lower than those in group A(P<0.05).At 12 hours,24 hours and 48 hours after surgery,the pain VAS scores of patients in group C were significantly lower than those in group B(P<0.05).The levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and interleukin-6(IL-6)1 day after surgery of patients in group B and group C were significantly lower than those in group A(P<0.05).The pressing times of analgesia pump and the duration of obvious pain within 48 hours after surgery of patients in group A were significantly more/longer than those in group B and group C(P<0.05),and the analgesic satisfaction score was significantly lower than those in group B and group C(P<0.05).The total incidence of analgesic adverse reactions in group C was significantly higher than those in group A and group B(P<0.05).Conclusion BMI may affect the individualized analgesic effect,inflammatory factors and safety of sufentanil in elderly patients undergoing PFNA surgery.Underweight patients may have insufficient analgesia,while overweight or obese patients may have excessive analgesia,which may affect the analgesic safety.关键词
体质量指数/老年患者/舒芬太尼/个体化镇痛/炎症因子/安全性Key words
body mass index/elderly patients/sufentanil/individualized analgesia/inflammatory factors/safety分类
医药卫生引用本文复制引用
顾克,王浩,陈铁胜,徐继康,田振..体质量指数对老年股骨近端防旋髓内钉手术后舒芬太尼镇痛效果的影响[J].局解手术学杂志,2025,34(6):540-543,4.基金项目
江苏省宿迁市科技指导计划(Z2019179) （Z2019179）
