Effect of Hydromorphone Hydrochloride combined with Ropivacaine brachial plexus block anesthesia on postoperative analgesia of upper limb fractures#br#
CHEN Yanmei QIAN Cheng▲
Department of Anesthesiology, Changzhou Medical District, 904th Hospital of the Joint Logistic Support Force of the Chinese People’s Liberation Army, Jiangsu Province, Changzhou 213000, China
Abstract：Objective To explore the effect of Hydromorphone Hydrochloride combined with Ropivacaine brachial plexus block anesthesia on postoperative analgesia of upper limb fractures. Methods A total of 122 patients with lower radius fractures admitted to 904th Hospital of the Joint Logistic Support Force of the Chinese People’s Liberation Army from October 2018 to April 2020. They were divided into study group (61 cases) and control group (61 cases) according to random number table method. The control group received Ropivacaine brachial plexus block anesthesia, and the study group used Hydromorphone Hydrochloride on the basis of the control group. The use of patient-controlled analgesia (PCA) and pain in two groups were recorded after surgery, serum pain mediators and drug safety of two groups were compared. Results The total PNA usage of both groups at 24 and 12 h after surgery was higher than that at 8 h, the total PCA usage at 12 h in both groups after surgery was higher than that at 12 h, and the differences were statistically significant (P < 0.05). The total PCA usage in study group at 8, 12, and 24 h after surgery was lower than that in control group, and the difference was statistically significant (P < 0.05). Visual analogue scale (VAS) scores of two groups at 24 and 12 h after surgery were higher than those at 4 h, VAS scores of two groups at 24 h after surgery were higher than those at 12 h, and the differences were statistically significant (P < 0.05). VAS of study group at 4, 12, and 24 h after surgery were lower than those of control group, and the differences were statistically significant (P < 0.05). At 24 h after surgery, the levels of prostaglandin E2 (PGE2), substance P (SP) and dopamine (DA) in two groups were higher than those before surgery, PGE2, SP, and DA of study group were lower than those of control group, and the differences were statistically significant (P < 0.05). There was no significant difference in the total incidence of adverse reactions between two groups (P > 0.05). Conclusion Hydromorphone Hydrochloride combined with Ropivacaine brachial plexus block anesthesia can reduce postoperative pain in patients with upper limb fractures, reduce the release of pain mediators, and have good safety.
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