摘要
目的探讨右美托咪定复合帕瑞昔布钠超前镇痛对老年髋关节骨折术后患者疼痛程度及炎症因子的影响。方法选取2018年4月至2019年3月鹤壁市人民医院麻醉科收治的89例行择期手术的老年髋关节骨折患者,男50例,女39例,年龄(75.35±4.87)岁,年龄范围为65~85岁,采用随机数表法将患者随机分为复合镇痛组(n=45)与常规麻醉组(n=44)。复合镇痛组麻醉前输注右美托咪定复合帕瑞昔布钠,常规麻醉组麻醉前输注相同体积的生理盐水,比较两组患者不同时间疼痛评分(VAS)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)水平及不良反应发生情况。结果复合镇痛组术毕[(1.53±0.55)分]、术后4 h[(2.27±0.66)分]、术后6 h[(2.09±0.64)分]、术后24 h[(1.56±0.65)分]的VAS低于常规麻醉组[(1.77±0.57)分、(2.59±0.69)分、(3.11±1.01)分、(2.58±0.81)分],差异有统计学意义(P<0.05)。复合镇痛组与常规麻醉组术毕IL-1β、IL-6水平比较,差异无统计学意义(P>0.05);复合镇痛组术后4 h[(11.54±2.37)pg/ml]、术后6 h(14.58±3.11)pg/ml]、术后24 h[(10.36±2.13)pg/ml]的IL-1β水平均低于常规麻醉组[(16.40±3.78)pg/ml、(20.14±4.85)pg/ml、(15.57±3.26)pg/ml],复合镇痛组术后4 h[(46.17±6.24)pg/ml]、术后6 h[(60.82±7.21)pg/ml]、术后24 h[(36.29±4.78)pg/ml]的IL-6水平均低于常规麻醉组[(63.20±7.74)pg/ml、(81.54±8.16)pg/ml、(50.36±6.54)pg/ml],差异均有统计学意义(P<0.05)。复合镇痛组不良反应发生率与常规麻醉组比较,差异无统计学意义(P>0.05)。结论右美托咪定复合帕瑞昔布钠超前镇痛能够提高老年髋关节骨折手术患者的麻醉效果,缓解患者术后疼痛,抑制机体炎症反应,且安全可靠。
Objective To investigate the effect of dexmedetomidine combined with parecoxib sodium on pain and inflammatory factors in elderly patients with hip fracture after advanced analgesia.Methods A retrospective study was performed on 89 cases of elderly patients with hip fracture who were admitted from April 2018 to March 2019.There were 40 males and 49 females,aged(75.35±4.87)years old,ranged from 65 to 85 years old.Patients were randomly divided into the combined analgesia group(n=45)and conventional anesthesia group(n=44).Dexmedetomidine combined with parecoxib sodium was injected into the combined analgesia group before anesthesia,and normal saline of the same volume was injected into the conventional anesthesia group before anesthesia.The levels of Visual Analog Scale(VAS),interleukin-1β(IL-1β)and interleukin-6(IL-6)of the two groups and the incidence of adverse reactions were compared.Results VAS in the combined analgesia group after[(1.53±0.55)points],4 hours after surgery[(2.27±0.66)points],6 hours after surgery[(2.09±0.64)points],and 24 h after surgery[(1.56±0.65)points]were lower than those in the conventional anesthesia group[(1.77±0.57)points,(2.59±0.69)points,(3.11±1.01)points,(2.58±0.81)points],and the difference was statistically significant(P<0.05).There was no significant difference in IL-1βand IL-6 levels between the combined analgesia group and the conventional anesthesia group(P>0.05).The level of IL-1 in the combined analgesia group was lower than that in the conventional anesthesia group[(16.40±3.78)pg/ml,(20.14±4.85)pg/ml,(15.57±3.26)pg/ml]at 4 h[(11.54±2.37)pg/ml],6 h[(14.58±3.11)pg/ml]and 24 h[(10.36±2.13)pg/ml].The level of IL-6 in the combined analgesia group was lower than that in the conventional anesthesia group[(63.20±7.74)pg/ml,(81.54±8.16)pg/ml,(50.36±6.54)pg/ml)at 4 h[(46.17±6.24)pg/ml],6 h[(60.82±7.21)pg/ml],and 24 h[(36.29±4.78)pg/ml],with statistically significant differences(P<0.05).There was no significant difference in the incidence of adverse reactions b
作者
刘彦超
赵艳艳
高颖
Liu Yanchao;Zhao Yanyan;Gao Ying(Department of Anesthesiology,Hebi People′s Hospital,Hebi 458030,China)
出处
《中国临床实用医学》
2020年第3期51-54,共4页
China Clinical Practical Medicine
关键词
右美托咪定
帕瑞昔布钠
超前镇痛
老年髋关节骨折
Dexmedetomidine
Parecoxib sodium
Advanced analgesia
Hip fracture in the elderly
