摘要
目的:探讨盐酸氢吗啡酮联合罗哌卡因用于骨科术后硬膜外自控镇痛(PCEA)对疼痛介质、炎症介质、氧自由基合成的影响。方法:收集在本院接受手术治疗的骨折患者120例,随机分为对照组、观察组各60例。对照组患者接受盐酸吗啡联合罗哌卡因镇痛,观察组患者接受盐酸氢吗啡酮联合罗哌卡因镇痛,术后持续镇痛48h。对比两组镇痛前后血清中疼痛介质、炎性介质、氧化应激指标含量的差异。结果:术后即刻,两组患者血清中疼痛介质、炎性介质、氧化应激指标含量的差异无统计学意义(P>0.05)。术后48h,两组患者血清中PGE2、SP、β-EP、IL-6、MCP-1、HMGB-1、MDA的含量均较术后即刻显著降低,Cu-Zn SOD、GSH-Px的含量均较术后即刻显著升高(P<0.05),且观察组患者血清中PGE2、SP、β-EP、IL-6、MCP-1、HMGB-1、MDA的含量均较对照组显著降低,Cu-Zn SOD、GSH-Px的含量均较对照组显著升高(P<0.05)。结论:骨科术后PCEA采用盐酸氢吗啡酮联合罗哌卡因,可有效缓解患者疼痛,抑制全身炎症应激反应。
Objective： To explore the effect of hydromorphone hydrochloride combined with ropivacaine for PCEA after orthopedic surgery on the synthesis of pain mediators, inflammatory mediator and oxygen free radicals. Methods： A total of 120 patients with fracture who underwent operation in the hospital group according to the random number table method, 60 cases were collected and divided into control group and observation in each group. Control group received morphine hydrochloride combined with ropivacaine for analgesia, observation group received hydromorphone hydrochloride combined with ropivacaine for analgesia, and the postoperative analgesia lasted for 48 h. The differences in serum levels of pain mediators, inflammatory mediators and oxidative stress indexes were compared between the two groups. Results： Immediately after operation, the differences in serum levels of pain mediators, inflammatory mediators and oxidative stress indexes were not statistically signifi- cant between the two groups （P〈0.05）. At 48 h after operation, serum PGE2, SP, β-EP, IL-6, MCP-1, HMGB-1 and MDA levels of both groups of patients were significantly lower than those immediately after operation while Cu-Zn SOD and GSH-Px levels were significantly higher than those immediately after operation （P〈0.05）, and serum PGE2, SP, β-EP, IL-6, MCP-1, HMGB-1 and MDA levels of observation group were significantly lower than those of control group while Cu-Zn SOD and GSH-Px levels were significantly higher than those of control group （P 〈0.05）. Conolusions： Hydromorphone hydrochloride combined with ropivacaine for PCEA after orthopedic surgery is effective in alleviating pain and inhibiting systemic inflammatory response.
出处
《海南医学院学报》
CAS
2017年第15期2086-2089,共4页
Journal of Hainan Medical University
基金
四川省卫生计生委基金项目(130250)
关键词
氢吗啡酮
吗啡
酰胺类
镇痛
硬膜外
Hydromorphone
Morphine
Amides
Analgesia
Epidural
作者简介
罗良英（1985-），女，四川内江人，本科，主治医师，电话：13541831370，E—mail：13541831370@163．com。
