摘要
目的:探究右美托咪定联合腰硬联合麻醉对股骨颈骨折患者术后疼痛、应激水平及负性情绪的影响。方法:选取2021年6月—2023年12月在商丘市中医院接受手术治疗的74例股骨颈骨折患者作为研究对象,随机分为对照组(n=37)和观察组(n=37)。术中,给予对照组腰硬联合麻醉,观察组则联用右美托咪定与腰硬联合麻醉,比较两组的疼痛程度[疼痛数字评定量表(NRS)评分、疼痛暴发次数、严重疼痛持续时间]、应激[去甲肾上腺素(NA)、肾上腺素(EPI)、皮质醇(Cor)]水平及负性情绪严重程度[抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分]。结果:术后6 h,观察组NRS评分低于对照组(P<0.05)。观察组术后48 d内疼痛暴发次数少于对照组,术后严重疼痛持续时间短于对照组(P<0.05)。术后6 h,两组NA、EPI、Cor水平均较术前升高,其中观察组升高幅度小于对照组(P<0.05)。术后24 h,两组SAS评分、SDS评分均较术前升高,其中观察组升高幅度小于对照组(P<0.05)。结论:在股骨颈骨折患者的手术中联用右美托咪定与腰硬联合麻醉能有效减轻术后疼痛,降低应激水平,缓解负性情绪。
Objective:To investigate the effects of dexmedetomidine combined with combined spinal-epidural anesthesia on postoperative pain,stress level and negative emotion in patients with femoral neck fracture.Methods:A total of 74 patients with femoral neck fracture who received surgical treatment in Shangqiu Hospital of Traditional Chinese Medicine from June 2021 to December 2023 were selected as the study objects,and randomly divided into control group(n=37)and observation group(n=37).During the operation,the control group was given combined spinalepidural anesthesia,while the observation group was given dexmedetomidine combined with combined spinal-epidural anesthesia.The degree of pain[Numerical Rating Scale(NRS)score,frequency of pain outbreaks,duration of severe pain],stress level[noradrenalin(NA),epinephrine(EPI),cortisol(COR)]and severity of negative emotion[Self-Rating Depression Scale(SDS)score,Self-rating Anxiety Scale(SAS)score]were compared between the two groups.Results:The NRS score of the observation group was lower than that of the control group at 6h after operation(P<0.05).The frequency of pain outbreak in the observation group was less than that in the control group in 48 days after operation,and the duration of severe pain after operation was shorter than that in the control group(P<0.05).The levels of NA,EPI and Cor at 6 h after operation in both groups were higher than those before operation,and the increase of the observation group was less than that of control group(P<0.05).24 h after operation,SAS scores and SDS scores in both groups were higher than those before operation,and the increase of the observation group was less than that of control group(P<0.05).Conclusion:Dexmedetomidine combined with combined spinal-epidural anesthesia can effectively alleviate postoperative pain,reduce stress level and relieve negative emotion during operation on patients with femoral neck fracture.
作者
李越
LI Yue(Department of Anesthesiology,Shangqiu Hospital of Traditional Chinese Medicine,Shangqiu 476000,China)
出处
《延边大学医学学报》
CAS
2024年第4期418-421,共4页
Journal of Medical Science Yanbian University
关键词
右美托咪定
腰硬联合麻醉
股骨颈骨折
术后疼痛
应激水平
负性情绪
dexmedetomidine
combined spinal-epidural anesthesia
femoral neck fracture
postoperative pain
stress level
negative emotion
