摘要
目的探讨应用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2019年7月—2021年3月在郑州市某医院接受手术治疗的93例老年髋关节骨折患者为研究对象,采用随机数字表法分为对照组(n=46)和观察组(n=47)。观察组患者在麻醉前输注右美托咪定复合帕瑞昔布钠,对照组患者在麻醉前输注相同体积的生理盐水。比较2组患者在术后不同时间点的疼痛程度[视觉模拟量表(VAS)评分]、炎症因子水平[白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)]、应激激素水平[皮质醇(CORT)、去甲肾上腺素(NE)]。结果在手术即刻,2组患者VAS评分比较,差异无统计学意义(P>0.05);在术后6 h与术后24 h,观察组患者VAS评分均低于对照组,差异均有统计学意义(P<0.05)。在手术即刻,2组患者IL-1β及IL-6水平比较,差异均无统计学意义(P>0.05);在术后6 h与术后24 h,观察组患者IL-1β及IL-6水平均低于对照组,差异均有统计学意义(P<0.05)。在手术即刻,2组患者CORT及NE水平比较,差异无统计学意义(P>0.05);在术后6 h与术后24 h,观察组患者CORT及NE水平均低于对照组,差异均有统计学意义(P<0.05)。结论对老年髋关节骨折患者术前应用右美托咪定复合帕瑞昔布钠超前镇痛可有效降低患者术后疼痛程度,降低炎症因子与应激激素水平的提升幅度,具有较高的临床推广价值。
Objective To investigate the effects of the preemptive analgesia of dexmedetomidine combined with parecoxib sodium on the pain level and inflammatory factors of elderly patients after hip fracture surgery.Methods Ninety-three elderly hip fracture patients who received surgical treatment in a hospital in Zhengzhou from July 2019 to March 2021 were enrolled for the study and divided into a control group(n=46)and an observation group(n=47)by a random number table.Patients in the observation group were infused with dexmedetomidine combined with parecoxib sodium before anesthesia,and patients in the control group were infused with the same volume of saline before anesthesia.The pain level as indicated by visual analog scale(VAS)scores,the levels of inflammatory factors interleukin-1β(IL-1β)and interleukin-6(IL-6)as well as the levels of stress hormones cortisol(CORT)and norepinephrine(NE)were compared between the 2 groups of patients at different time points after surgery.Results In the immediate postoperative period,there was no statistically significant difference between the VAS scores of patients in the 2 groups(P>0.05);at 6 h and 24 h after surgery,the VAS scores of patients in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).In the immediate postoperative period,the differences between the IL-1βand IL-6 levels in the 2 groups were not statistically significant(P>0.05);at 6 h and 24 h after surgery,the IL-1βand IL-6 levels in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).In the immediate postoperative period,there was no statistically significant difference between the CORT and NE levels in the 2 groups(P>0.05);at 6 h and 24 h after surgery,the CORT and NE levels of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion The preoperative application of dexmedetomidine combined with parecoxib sodium as preemptive analgesia for elderly hip fracture patients can effectively reduce the postoperative pain level and decrease the elevation of inflammatory factors and stress hormone levels,and thus has high value for clinical practice.
作者
任莹莹
郭晓辉
杨毛香
Ren Yingying;Guo Xiaohui;Yang Maoxiang(Department of Anesthesiology,Henan No.3 Provincial People's Hospital,Zhengzhou 450006,China)
出处
《保健医学研究与实践》
2022年第5期66-69,共4页
Health Medicine Research and Practice
