氢吗啡酮联合地佐辛对膝关节置换术患者术后镇痛效果及疼痛因子水平的影响

Effects of Hydromorphone Combined with Dezocine on Postoperative Analgesia and Pain Factor Levels in Patients with Knee Prosthesis

目的探讨膝关节置换术患者给予氢吗啡酮联合地佐辛对术后镇痛效果及疼痛因子水平的影响。方法方便选取2020年5月—2021年7月在定西人民医院接受膝关节置换术的患者104例为研究对象,采用随机摸球法分为A组(n=52)与B组(n=52)。B组给予单纯氢吗啡酮镇痛,A组给予氢吗啡酮联合地佐辛镇痛,比较两组术后镇痛效果、疼痛因子水平、炎性因子水平及不良反应发生率。结果A组术后4、12、48、72 h的视觉模拟评分法(VAS)评分(0.89±0.32)分、(3.06±0.85)分、(2.65±0.73)分、(1.87±0.95)分与B组(1.67±0.45)分、(4.53±1.41)分、(3.98±1.25)分、(2.83±0.71)分相比均明显更低,差异有统计学意义(t=10.186、6.439、6.626、5.837,P<0.001);两组术后24 h的P物质(SP)、缓激肽(BK)、组胺(HIS)、5-羟色胺(5-HT)水平均有明显提高,但A组与B组相比明显更低,差异有统计学意义(P<0.05);两组术后24 h的白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、干扰素γ(IFN-γ)水平均有明显提高,但A组与B组相比明显更低,差异有统计学意义(P<0.05);A组不良反应发生率(11.54%)与B组(28.85%)相比明显更低,差异有统计学意义(χ^(2)=4.833,P=0.028)。结论膝关节置换术患者给予氢吗啡酮联合地佐辛,能够提升术后镇痛效果,调节疼痛因子及炎性因子水平,具有较高的安全性。

Objective To investigate the effect of hydromorphone combined with dezocine on postoperative analgesia and pain factor levels in patients undergoing knee prosthesis. Methods 104 patients who underwent knee prosthesis in Dingxi People’s Hospital from May 2020 to July 2021 were conveniently selected as research object. The patients were divided into group A(n=52) and group B(n=52) by random touch-ball method. Group B was given hydromorphone alone for analgesia, and group A was given hydromorphone combined with dezocine for analgesia. The postoperative analgesic effect, pain factor levels, inflammatory factor levels and incidence of adverse reactions were compared between the two groups. Results The Visual Analogue Scale(VAS) scores of group A at 4 h, 12 h, 48 h and 72 h after operation were(0.89±0.32) points,(3.06±0.85) points,(2.65±0.73) points,(1.87±0.95) points were significantly lower than those of group B(1.67±0.45) points,(4.53±1.41) points,(3.98±1.25) points, and(2.83±0.71) points, and the difference was statistically significant(t=10.186, 6.439, 6.626, 5.837, P<0.001). The levels of substance P(SP), bradykinin(BK), histamine(HIS), and 5-hydroxy-tryptamine(5-HT) in the two groups were significantly increased at 24 h after operation, but group A was significantly lower than group B, and the difference was statistically significant(P<0.05). The levels of interleukin-1β(IL-1β), interleukin-6(IL-6) and interferon γ(IFN-γ) were significantly increased in the two groups at 24 h after operation, but group A was significantly lower than group B, and the difference was statistically significant(P<0.05). The incidence of adverse reactions in group A(11.54%) was significantly lower than that in group B(28.85%), and the difference was statistically significant(χ^(2)=4.833, P=0.028). Conclusion Hydromorphone combined with dezocine in patients undergoing knee prosthesis can improve postoperative analgesia and regulate the levels of pain factors and inflammatory factors, with high safety.