【摘要】 目的：探讨氢吗啡酮单用与舒芬太尼、布托啡诺联用对全麻下肩关节手法松解术后的镇痛效果差异。方法：以2022年1月—2024年12月我院收治的102例需行肩关节手法松解术的冻结肩患者为研究对象，根据术后镇痛方式分为2组，A组术后采用单纯氢吗啡酮静脉泵入镇痛，B组术后采用舒芬太尼联合布托啡诺静脉泵入镇痛，利用视觉模拟评分法(visual analog scale，VAS)评估患者疼痛程度，利用Constant-Murley 评分量表评估患者肩关节功能，通过免疫荧光法测定皮质醇(cortisol，Cor)、去甲肾上腺素(norepinephrine，NE)、血糖水平(blood glucose，BG)表达评估患者应激反应，另外记录患者术后镇痛期间不良反应发生情况。结果：(1)A组术后0.5、12、24、48、72?h的VAS评分均低于B组；(2)A组术后0.5、12、24、48、72?h的Constant-Murley评分均高于B组；(3)A组术后24、48、72?h Cor、NE、BG均低于B组；(4)A组与B组术后镇痛期间不良反应发生率差异无统计学意义。结论：单用氢吗啡酮对全麻下肩关节手法松解术后的镇痛效果优于“舒芬太尼+布托啡诺”方案，能促进肩关节功能恢复，且安全性良好，具备推广价值。更多还原

【Abstract】 Objective To investigate the analgesic efficacy differences between monotherapy with hydromorphone and combination therapy with sufentanil and buprenorphine after total shoulder manipulation under general anesthesia.Methods A total of 102 frozen shoulder patients requiring shoulder manipulation surgery admitted to our hospital from January 2022 to December 2024 were enrolled.Patients were divided into two groups based on postoperative analgesia.Methods Group A received pure hydromorphone intravenous pump analgesia,while Group B received sufentanil combined with buprenorphine intravenous pump analgesia.Pain levels were assessed using Visual Analog Scale (VAS),and shoulder function was evaluated with Constant-Murley scale.Stress response was measured through immunofluorescence assays for cortisol (Cor),norepinephrine (NE),and blood glucose (BG) levels.Adverse reactions during postoperative analgesia were recorded.Results (1) Group A showed lower VAS scores at 0.5,12,24,48,and 72?h postoperatively compared to Group B;(2) Group A demonstrated higher Constant-Murley scores at 0.5,12,24,48,and 72?h postoperatively than Group B;(3) Group A exhibited lower Cor,NE,and BG levels at 24,48,and 72 h postoperatively compared to Group B;(4) No statistically significant difference in adverse reaction incidence was observed between Groups A and B during postoperative analgesia.Conclusion The analgesic effect of morphine alone after shoulder manual release under general anesthesia is better than the combination of sufentanil and buprotin,which can promote shoulder joint function recovery and has good safety,and has the value of promotion.更多还原