超前镇痛对老年下肢骨折患者术后疼痛及相关神经递质表达的影响  

Influence of Preemptive Analgesia on Postoperative Pain and Expression of Related Neurotransmitters of Elderly Patients with Lower Limb Fracture

作　　者：刘全成[1] LIU Quancheng(Jiamusi Central Hospital,Jiamusi 154002,China)

机构地区：[1]黑龙江省佳木斯市中心医院,黑龙江佳木斯154002

出　　处：《中国医学创新》2021年第19期118-122,共5页Medical Innovation of China

基　　金：黑龙江省卫生健康委科研课题(2019-343)

摘　　要：目的:探讨超前镇痛对老年下肢骨折患者术后疼痛及相关神经递质表达的影响。方法:选择本院2018年9月-2020年9月收治的110例老年下肢骨折患者,根据随机数字表法将其分为观察组及对照组,每组55例。观察组给予超前镇痛,于手术切皮前30 min静脉注射酮咯酸氨丁三醇注射液0.5 mg/kg及地佐辛注射液0.1 mg/kg,对照组不给予超前镇痛。比较两组手术情况,术后24 h舒芬太尼用量及自控镇痛泵的按压次数,术前(T0)及术后4 h(T1)、8 h(T2)、12 h(T3)、24 h(T4)疼痛情况及术前和术后24 h的相关神经递质水平。结果:观察组头晕7例,恶心、呕吐8例,对照组头晕7例,恶心、呕吐6例。两组术中出血量、手术时间、苏醒时间、意识恢复时间及不良反应发生率比较,差异均无统计学意义(P>0.05)。观察组术后24 h舒芬太尼用量及自控镇痛泵的按压次数均少于对照组,差异均有统计学意义(P<0.05)。T0时,两组VAS评分比较,差异均无统计学意义(P>0.05);T1、T2、T3、T4时,观察组的VAS评分均低于对照组,差异均有统计学意义(P<0.05)。术前,两组PGE2、SP、E、NE比较,差异均无统计学意义(P>0.05);术后24 h,两组PGE2、SP、E、NE高于术前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。结论:超前镇痛可减少老年下肢骨折患者术后疼痛及相关神经递质表达,也减少术后镇痛药物的应用。Objective:To explore the influence of preemptive analgesia on postoperative pain and expression of related neurotransmitters of elderly patients with lower limb fracture.Method:A total of 110 elderly patients with lower limb fracture admitted to our hospital from September 2018 to September 2020 were selected,and they were randomly divided into observation group and control group according to number table method,55 cases in each group.The observation group was given preemptive analgesia,Ketorolac Tromethamine Injection 0.5 mg/kg and Dezocine Injection 0.1 mg/kg were injected intravenously 30 min before surgical skin cutting.While the control group was not given preemptive analgesia.The surgical situation,the amount of Sufentanil and the number of compressions of the automatic analgesia pump at 24 h after surgery were compared between the two groups,the preoperative(T0)and postoperative 4 h(T1),8 h(T2),12 h(T3),24 h(T4)pain conditions,and the relevant neurotransmitters levels before and 24 h after surgery were compared between two groups.Result:There were 7 cases of dizziness,8 cases of nausea and vomiting of observation group,and 7 cases of dizziness,6 cases of nausea and vomiting of control group.There were no significant differences in the amount of intraoperative blood loss,surgical time,recovery time,consciousness recovery time and incidence of adverse reactions between two groups(P>0.05).24 h after surgery,the amount of Sufentanil and the number of compressions of the automatic analgesia pump of observation group were less than those of control group,and the differences were statistically significant(P<0.05).At T0,there was no statistically significant difference in VAS scores between two groups(P>0.05);at T1,T2,T3 and T4,the VAS scores of observation group were lower than those of control group,and the differences were statistically significant(P<0.05).Before surgery,there were no significant differences in PGE2,SP,E and NE between two groups(P>0.05);24 h after surgery,PGE2,SP,E and NE in both groups were h

关 键 词：超前镇痛 术后疼痛 下肢骨折 神经递质 

分 类 号：R614[医药卫生—麻醉学]