|
|
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.
|
|
|
|
|
[1] 贺达,成永忠,赵勇,等.半环式外固定架治疗C型桡骨远端骨折[J].中国矫形外科杂志,2019,27(8):15-19.
[2] 尹航.健康教育在桡骨下端骨折患者进行小夹板固定治疗中的效果观察[J].求医问药(学术版),2012,10(10):219-220.
[3] 杨永生,肖梦熊,陈珞珈,等.以桡骨远端骨折为中医优势病种的历史成本费用结构分析[J].中国卫生经济,2020, 39(12):68-70.
[4] 姜静雯,盛崴宣,关雷.右美托咪定在淋巴静脉吻合术臂丛神经阻滞中的应用[J].中国微创外科杂志,2019,19(3):248-250,255.
[5] 王玥,高歌,赵国庆,等.氯普鲁卡因应用于超声引导下臂丛神经阻滞的临床观察[J].中国实验诊断学,2018,22(1):84-86.
[6] 丁连仁,刘晓云.超声引导下臂丛神经阻滞的临床效果分析[J].中国社区医师,2019,35(29):20-21.
[7] 谷寅,刘友坦. 关节镜肩部手术后肌间沟阻滞复合口服镇痛药物的镇痛效果[J].中国医师杂志,2020,22(10):1543-1546.
[8] 马岳,李慧莉,吴泽昊,等.L3椎旁神经阻滞联合骶前-腰大肌后间隙阻滞对全膝关节置换术后患者自控静脉镇痛的影响[J].国际麻醉学与复苏杂志,2019,40(12):1117-1121.
[9] 袁珂,李凯,刘岩,等.腰方肌阻滞联合非甾体类药物在剖宫产术后镇痛中的效果[J].中国实验诊断学,2020,24(3):111-113.
[10] 张亮,黄吉军,巫一鸣,等.多模式镇痛在局部麻醉经皮椎间孔镜术中的应用[J].中国骨与关节损伤杂志,2019, 34(7):690-693.
[11] 王玉,尚宇,张祥超,等.氢吗啡酮混合罗哌卡因PCEA用于肾移植术后镇痛的效果[J].广东医学,2019,40(22):63-67.
[12] 柏耀林,许克路,范光洁.不同剂量盐酸氢吗啡酮应用于剖宫产术后镇痛效果及预后影响[J].解放军预防医学杂志,2019,37(8):181-182.
[13] 赵富丽,张开芳,陈运芳,等.盐酸羟考酮在中,重度癌痛患者中的应用效果研究[J].中国医药导报,2013,10(8):68-69.
[14] 王学艳,任华丽,石海云,等.变应性鼻炎症状评分及视觉模拟量表适用性比较[J].中国耳鼻咽喉头颈外科,2012,19(11):609-611.
[15] 李静,王武涛,赵玲,等.罗哌卡因用于超声引导下肋锁间隙臂丛神经阻滞的半数有效浓度[J].国际麻醉学与复苏杂志,2020,41(7):682-685.
[16] 孙大健,张洁.右美托咪定联合罗哌卡因用于超声引导下肌间沟臂丛神经阻滞的麻醉效果观察[J].海南医学,2019,30(5):69-71.
[17] 叶姣,薛荣亮.不同浓度和剂量盐酸罗哌卡因对超声引导下臂丛神经阻滞效果的影响[J].陕西医学杂志,2019, 48(1):55-57.
[18] 柯纬祺,姚健春,熊飞,等.0.4%罗哌卡因用于超声联合神经刺激器肌间沟臂丛神经阻滞最低有效剂量的研究[J].中国医师杂志,2020,22(2):266-269.
[19] 于天雷,李曼,刘颖.不同剂量罗哌卡因在超声引导下腋路臂丛神经阻滞中的麻醉效果[J].中国医师杂志,2020,22(4):555-558.
[20] 王增涛,杨黎明.高压氧辅助治疗对跟骨骨折患者疼痛及血清5-羟色胺和P物质的影响[J].中华航海医学与高气压医学杂志,2019,26(3):187-190.
[21] 柯雪茹,雷波,王明春,等.疼痛敏感性及阿片类镇痛药用量与多巴胺转运体基因多态性的相关性[J].临床麻醉学杂志,2019,35(12):1153-1156.
[22] 曹迪,张亚密.加味芍药甘草汤辅助治疗对癌性疼痛患者疼痛介质及炎性因子的影响[J].中国医药导报,2020, 17(7):143-146.
[23] 孟利刚,马星钢,胥亮,等.盐酸氢吗啡酮复合氟比洛芬酯用于小儿术后镇痛的有效性和安全性[J].广东医学,2019(15):2197-2200.
[24] 王承志,甘建辉,涂青,等.氢吗啡酮联合罗哌卡因对髋关节置换术患者术后认知功能的影响[J].医药导报,2019,38(5):610-613.
[25] 廖强,王兆,刘静.盐酸氢吗啡酮联合静脉泵镇痛对剖宫产产妇的镇痛效果及恢复情况的影响[J].中国性科学,2020,29(4):83-86.
[26] 苏圣贤,解小丽,林志光,等.盐酸氢吗啡酮超前镇痛对剖宫产术后血清TNF-α、SP表达及VAS评分的影响[J].临床和实验医学杂志,2021,20(16):1756-1760.
[27] 林慧梅.硬膜外腔注射不同剂量盐酸氢吗啡酮对剖宫产术后镇痛效果和安全性分析[J].中外医学研究,2018, 16(4):51-52. |
|
|
|