【摘要】 目的 观察草乌甲素在老年髋部骨折患者围术期多模式镇痛中的效果。方法 选取2020年7月～2021年6月收治的80例接受手术治疗的老年髋部骨折患者作为研究对象，按照随机数字表法分为试验组和对照组，各40例。对照组采用常规多模式镇痛方案，试验组在对照组的基础上增加草乌甲素。视觉模糊评分法(VAS)评估两组的镇痛效果，对比两组静脉自控镇痛泵按压例数，盐酸哌替啶注射例数，以及恶心、呕吐、尿潴留、皮肤瘙痒、皮疹、呼吸抑制等不良反应的发生情况。结果 试验组麻醉前、术后12、24、36、48、72 h的疼痛程度VAS评分低于对照组(P<0.05),试验组达到无痛或轻度疼痛时间早于对照组(P<0.05),试验组静脉自控镇痛泵按压例数、盐酸哌替啶注射例数均少于对照组(P<0.05),试验组术后恶心、呕吐发生率少于对照组(P<0.05);两组术后呼吸抑制、尿潴留、皮肤瘙痒、皮疹发生率比较，差异均无统计学意义(P>0.05)。结论 联合草乌甲素的多模式镇痛方案对减轻老年髋部骨折患者围术期急性疼痛有良好的效果，可以减少阿片类药物的需求以及镇痛药的不良反应。更多还原

【Abstract】 Objective To observe the effect of bulleyaconitine A on perioperative multimodal analgesia in older patients with hip fracture.Methods Eighty older patients with hip fracture undergoing surgical treatment from July 2020 to June 2021 were selected in this study.The patients were divided into an experimental group(40 cases) and a control group(40 cases) according to random number table.Both groups were treated with conventional multimodal analgesia scheme.The experimental group was additionally treated with bulleyaconitine A.Visual analogue scale(VAS) was used to evaluate the analgesic effect in two groups.The number of patients pressing the patient controlled intravenous analgesia(PCIA) pump, the number of patients receiving pethidine hydrochloride, and the occurrence of adverse reactions(such as nausea, vomiting, urinary retention, skin itch, rash, respiratory depression)were compared between the two groups.Results VAS scores in the experimental group were significantly lower than those in the control group before anesthesia, and 12,24,36,48 and 72 hours after operation(P<0.05).The time to achieve no pain or mild pain in the experimental group was significantly shorter than that in the control group(P<0.05).The number of patients pressing PCIA pump and the number of patients receiving pethidine hydrochloride in the experimental group were significantly less than those in the control group(P<0.05).The incidence of postoperative nausea and vomiting in the experimental group was significantly lower than that in the control group(P<0.05).There was no significant difference in the incidence of postoperative respiratory depression, urinary retention, skin itch and rash between the two groups(P>0.05).Conclusion The multimodal analgesic scheme combined with bulleyaconitine A may effectively alleviate the perioperative acute pain in older patients with hip fracture, and reduce the demand for opioids and the adverse reactions of analgesic drugs.更多还原