帕瑞昔布钠超前镇痛联合舒芬太尼PCIA在老年人工全膝关节置换术后的镇痛效果及对炎症因子、氧化应激反应的影响  

Analgesic Effect of Preemptive Analgesia with Parecoxib Sodium Combined with Sufentanil PCIA after Total Knee Arthroplasty in the Elderly and its Impact on Inflammatory Factors and Oxidative Stress Responses

作　　者：钟福如 王景坤[1] 苏柏勤 ZHONG Fu-ru;WANG Jing-kun;SU Bai-qin(Department of Anesthesiology,Dongguan People's Hospital,Dongguan 523000,China)

机构地区：[1]东莞市人民医院麻醉科,广东东莞523000

出　　处：《药物生物技术》2023年第5期503-507,共5页Pharmaceutical Biotechnology

基　　金：东莞市社会发展科技项目(No.20211800903412)。

摘　　要：探讨帕瑞昔布钠超前镇痛联合和舒芬太尼静脉自控镇痛(PCIA)在老年人工全膝关节置换术(TKA)后的镇痛效果及对炎症因子、氧化应激反应的影响。选择2020年7月~2022年8月在本院行TKA治疗的80例患者作为研究对象,用随机数表法分为两组,每组各40例。对照组给予舒芬太尼PCIA镇痛,观察组在对照组基础上给予帕瑞昔布钠超前镇痛联合舒芬太尼PCIA镇痛。比较两组术前1 h、术后6、12、24、48 h的视觉模拟疼痛(VAS)评分、炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]及氧化应激反应指标[皮质醇(Cor)、肾上腺素(E)]情况,并统计两组的不良反应。术后6 h、术后12 h、术后24 h、术后48 h两组的VAS评分均较术前1 h降低,且观察组上述各时间点的VAS评分均低于对照组(P<0.05);术后6 h、术后12 h、术后24 h、术后48 h两组的IL-6、TNF-α均较术前1 h升高,但观察组各时间点的IL-6、TNF-α均低于对照组(P<0.05);术后6 h、术后12 h、术后24 h、术后48 h两组的Cor、E均较术前1 h升高,但观察组上述各时间点的Cor、E均低于对照组(P<0.05);观察组不良反应发生率为5.00%,低于对照组(22.50%,P<0.05)。帕瑞昔布钠超前镇痛联合舒芬太尼PCIA应用于老年TKA术后镇痛效果理想,可有效改善患者的炎症反应及氧化应激反应,减少不良反应,值得在临床推广运用。To investigate the analgesic effect of preemptive analgesia with Paroxyxib sodium combined with patient-controlled intravenous analgesia with sufentanil(PCIA)after total knee arthroplasty(TKA)in the elderly and its impact on inflammatory factors and oxidative stress responses,80 patients who underwent TKA treatment in the authors'hospital from July 2020 to August 222 were selected as the study subjects.They were divided into two groups using a random number table method,with 40 patients in each group.The control group was given sufentanil PCIA for analgesia,while the observation group was given parecoxib sodium preemptive analgesia combined with sufentanil PCIA for analgesia based on the control group.The visual analogue pain(VAS)scores,inflammatory factors[Interleukin-6(IL-6),Tumor necrosis factor-α(TNF-α)],and oxidative stress response indicators[Cortisol(Cor),Epinephrine(E)]were compared between the two groups at 1 h before surgery,6 h,12 h,24 h,and 48 h after surgery,and the adverse reactions in the two groups were statistically analyzed.The VAS scores of the two groups at 6 hours,12 hours,24 hours,and 48 hours after surgery were lower than those at 1 hour before surgery,and the VAS scores of the observation group at the above time points were lower than those of the control group(P<0.05);The levels of IL-6 and TNF-αin the two groups at 6 hours,12 hours,24 hours,and 48 hours after surgery were higher than those at 1 hour before surgery,but the levels of IL-6 and TNF-αin the observation group were lower than those in the control group at each time point(P<0.05);The Cor and E of the two groups at 6 hours,12 hours,24 hours,and 48 hours after surgery were higher than those at 1 hour before surgery,but the Cor and E of the observation group at the above time points were lower than those of the control group(P<0.05);The incidence of adverse reactions in the observation group was 5.00%lower than that in the control group(22.50%,P<0.05).Preemptive analgesia with parecoxib sodium combined with sufentanil PCIA for

关 键 词：人工全膝关节置换术 帕瑞昔布钠 舒芬太尼 镇痛 炎症因子 氧化应激反应 不良反应 

分 类 号：R614[医药卫生—麻醉学]