Influence of body mass index on the analgesic effect of sufentanil in elderly patients after proximal femoral nail anti-rotation surgery

GU Ke; WANG Hao; CHEN Tie-sheng; XU Ji-kang; TIAN Zhen

doi:10.11659/jjssx.07E024084

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Influence of body mass index on the analgesic effect of sufentanil in elderly patients after proximal femoral nail anti-rotation surgery

Clinical Research | 更新时间：2025-06-17

- Influence of body mass index on the analgesic effect of sufentanil in elderly patients after proximal femoral nail anti-rotation surgery
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 6, Pages: 540-543(2025)
- 作者机构：
  
  南京鼓楼医院集团宿迁医院麻醉科，江苏宿迁 223800
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.07E024084
  CLC： R971
- Received：15 July 2024，
  
  Published：25 June 2025
- 稿件说明：
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顾克,王浩,陈铁胜等.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(06):540-543.

GU Ke,WANG Hao,CHEN Tie-sheng,et al.Influence of body mass index on the analgesic effect of sufentanil in elderly patients after proximal femoral nail anti-rotation surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(06):540-543.
顾克,王浩,陈铁胜等.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(06):540-543. DOI： 10.11659/jjssx.07E024084.

GU Ke,WANG Hao,CHEN Tie-sheng,et al.Influence of body mass index on the analgesic effect of sufentanil in elderly patients after proximal femoral nail anti-rotation surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(06):540-543. DOI： 10.11659/jjssx.07E024084.

摘要

目的

探讨体质量指数(BMI)对老年患者股骨近端防旋髓内钉(PFNA)手术后舒芬太尼个体化镇痛效果、炎症因子和安全性的影响。

方法

选取2022年1月至2023年12月在南京鼓楼医院集团宿迁医院行PFNA手术的老年患者161例为研究对象，将BMI

18.5 kg/m

的患者设为A组，BMI 18.5~23.9 kg/m

的患者设为B组，BMI 24.0~35.0 kg/m

的患者设为C组。术后根据体质量给予2 μg/kg舒芬太尼的静脉自控镇痛泵进行个体化镇痛，比较3组患者术后疼痛程度、炎症因子、镇痛情况和不良反应。

结果

在术后8 h、12 h、24 h和48 h，B组和C组患者的疼痛视觉模拟量表（VAS）评分均显著低于A组（

0.05）；在术后12 h、24 h和48 h，C组患者的疼痛VAS评分均显著低于B组（

0.05）。术后1 d，B组和C组患者的肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）和白细胞介素-6（IL-6）水平均显著低于A组（

0.05）。A组患者术后48 h内镇痛泵按压次数和疼痛明显时间均显著多/长于B组和C组（

0.05），镇痛满意度评分明显低于B组和C组（

0.05）。C组患者的镇痛不良反应发生率显著高于A组和B组（

0.05）。

结论

BMI会对PFNA手术老年患者的舒芬太尼个体化镇痛效果、炎症因子和安全性产生影响，体型较瘦的患者可能存在镇痛不足，而超重或肥胖患者可能存在过度镇痛而影响其镇痛安全性。

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/m

were set as Group A， patients with BMI ranging from 18.5 kg/m

to 23.9 kg/m

were set as Group B，patients with BMI ranging from 24.0 kg/m

to 35.0 kg/m

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 （

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 （

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 （

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 （

0.05）， and the analgesic satisfaction score was significantly lower than those in group B and group C （

0.05）. The total incidence of analgesic adverse reactions in group C was significantly higher than those in group A and group B （

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

Keywords

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