低吗啡综合镇痛方式在术后镇痛领域的临床应用  

Clinical application of low morphine comprehensive analgesia in postoperative analgesia

作　　者：李敬[1] 朱新炜[1] 黄波[1] 张华 臧睿[2] LI Jing;ZHU Xinwei;HUANG Bo;ZHANG Hua;ZANG Rui(Department of Surgery of the Fourth People's Hospital of Jinan,Jinan 250031,China;Surgery Department of Jinan Central Hospital,Jinan 250013,China)

机构地区：[1]济南市第四人民医院外科,济南250031 [2]济南市中心医院外科,济南250013

出　　处：《科技导报》2024年第19期113-118,共6页Science & Technology Review

摘　　要：为评价综合镇痛方式的疗效、安全性,观察了氢吗啡酮联合布托啡诺静脉自控镇痛对术后疼痛递质、炎症因子及氧化应激水平的影响。以骨科术后患者为研究对象,随机分为联合麻醉组(氢吗啡酮联合布托啡诺)和对照组(布托啡诺),利用血清P物质(SP)、前列腺素E2(PGE2)、β-内啡肽(β-EP)作为疼痛递质指标,利用白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)作为炎症因子指标,利用皮质醇(Cor)、去甲肾上腺素(NE)作为氧化应激指标,利用疼痛的视觉模拟评分(VAS)来衡量临床镇痛疗效。结果显示,联合组术后的疼痛VAS更低,进一步降低了血清SP、PGE2、NE、Cor水平,提高了β-内啡肽水平,降低了不良反应发生率。说明布托啡诺联合低剂量氢吗啡酮能进一步降低疼痛递质的水平、减轻氧化应激反应,提高疼痛阈值、降低患者的疼痛程度,提高麻醉安全性。This study observed the effects of intravenous patient-controlled analgesia with hydromorphone combined with butorphanol on postoperative pain neurotransmitters,inflammatory factors,and oxidative stress levels,aiming to evaluate the efficacy,safety,and application value of comprehensive analgesic methods.Postoperative orthopedic patients were randomly divided into a study group(with a combination of hydromorphone and butorphanol)and a control group(with butorphanol alone for pain relief).Serum substance P(SP),prostaglandin E2(PGE2)and beta endorphin(β-EP)were used as pain neurotransmitter markers,interleukin-6(IL-6)and tumor necrosis factor alpha(TNF-α)were used as inflammatory cytokine markers,cortisol(Cor)and norepinephrine(NE)were used as oxidative stress markers,and Visual Analog Scale(VAS)was used to measure clinical analgesic efficacy.The results showed that the combined group had a lower post-operative VAS,which further reduced the serum SP,PGE2,NE,Cor levels,increased theβ-endorphin levels,and reduced the incidence of adverse reactions.The combination of butorphanol and low-dose hydromorphone can further reduce the levels of pain transmitters,alleviate oxidative stress reactions,increase pain thresholds,reduce patient pain levels,and improve anesthesia safety.

关 键 词：术后镇痛 综合镇痛方式 低剂量 疼痛递质 炎症因子 氧化应激反应 麻醉安全性 

分 类 号：R614[医药卫生—麻醉学]