摘要
目的 评估不同药物镇痛方案用于剖宫产术后镇痛的有效性及药物成本-效果分析,为临床选择安全有效经济的治疗方案提供参考。方法 随机抽取郑州市妇幼保健院产科某病区2021年1~7月期间剖宫产手术病例116例,其中使用布托啡诺+地佐辛+右美托咪定混合后PCIA给药的30例,使用布托啡诺+氟比洛芬酯混合后PCIA给药的45例,使用布托啡诺PCIA给药+氟比洛芬酯静脉注射给药的41例。通过评估不同药物镇痛方案的镇痛效果,记录用药期间的不良反应,计算镇痛成本,对不同药物镇痛方案进行有效性和成本-效果分析。结果 3种镇痛方案48 h内疼痛缓解率(静息状态和功能活动状态的累计NRS评分3分以下累计频率)分别为33.3%,50.5%,32.9%,差异具有统计学意义(P<0.05);48 h内重度疼痛的发生率(静息状态和功能活动状态的累计NRS评分7~10分累计频率)分别为12.5%,5.5%,13.4%,差异有统计学意义(P<0.05)。不良反应总发生率差异有统计学意义(P<0.05);人均药物镇痛成本分别为(1 393.6±28.1)元、(582.7±18.7)元、(633.7±21.4)元;各组成本/效果(C/E)比分别为41.85,11.54,19.26,差异有统计学意义(P<0.05)。结论 布托啡诺+氟比洛芬酯混合后PCIA给药方案具有明显的成本-效果优势,具有普遍的应用意义。
OBJECTIVE To evaluate the effectiveness and the cost-effectiveness of different drug analgesia schemes for postoperative analgesia after cesarean section, so as to provide a safe, efficient and economical treatment scheme for clinicist. METHODS 116 cases of cesarean section in an obstetric ward of Zhengzhou maternal and child health hospital from January 2021 to July 2021 were randomly selected, including 30 cases treated with patient controlled intravenous analgesia(PCIA) after butorphanol + dizocine + dexmedetomidine, 45 cases treated with PCIA after butorphanol+flurbiprofen axetil, and 41 cases treated with PCIA after butorphanol + flurbiprofen axetil. By evaluating the analgesic effect of different drug analgesic programs, recording the adverse reactions during medication, calculating the analgesic cost, the effectiveness and cost-effectiveness of different drug analgesic programs were analyzed. RESULTS The pain relief rates of the three analgesic schemes within 48 hours(the cumulative frequency of NRS score less than 3 points in resting state and functional activity state) were 33.3%,50.5% and 32.9% respectively(P<0.05). The incidence of severe pain within 48 hours(cumulative NRS score of 7-10 points in resting state and functional activity state, cumulative frequency) were 12.5%,5.5% and 13.4% respectively, and the difference was statistically significant(P<0.05). There was significant difference in the total incidence of adverse reactions(P<0.05). The per capita cost of drug analgesia was(1 393.6±28.1) yuan,(582.7±18.7) yuan and(633.7±21.4) yuan respectively. The cost/effectiveness(C/E)ratios of each group were 41.85,11.54 and 19.26 respectively, with significant difference(P<0.05). CONCLUSION The PCIA administration scheme after butorphanol + flurbiprofen axetil has obvious cost-effectiveness advantages and has universal application significance.
作者
雷伟
赵路
李亚丽
程玉敏
苗杨
马新秀
姚尧
LEI Wei;ZHAO Lu;LI Yali;CHENG Yumin;MIAO Yang;MA Xinxiu;YAO Yao(Department of Pharmacy,Zhengzhou Maternal and Child Health Care Hospital,Zhengzhou,Henan 450003,China;Obstetrics DepartmentZhengzhou Maternal and Child Health Care Hospital,Zhengzhou,Henan 450003,China;Department of Anesthesiology,Zhengzhou Maternal and Child Health Care Hospital,Zhengzhou,Henan 450003,China)
出处
《今日药学》
CAS
2022年第10期773-777,共5页
Pharmacy Today
基金
河南省医学科技攻关计划联合共建项目(LHGJ20200741)。
关键词
剖宫产术后疼痛
药物镇痛方案
成本-效果分析
postoperative analgesia after cesarean section
drug analgesia schemes
cost-effectiveness analysis
