盐酸氢吗啡酮超前镇痛对腰椎融合术患者术后镇痛及炎性细胞因子的影响

Effect of preemptive analgesia with hydromorphone hydrochloride on postoperative analgesia and inflammatory cytokines in patients undergoing lumbar fusion surgery

目的探讨盐酸氢吗啡酮超前镇痛对腰椎融合术患者术后镇痛及炎性细胞因子的影响。方法将40例拟行腰椎融合术的患者随机分为盐酸氢吗啡酮组(A组)和对照组(B组),每组20例。记录两组患者手术情况,术后2 h(T_(1))、8 h(T_(2))、12 h(T_(3))、24 h(T_(4))、48 h(T_(5))的静息状态VAS评分、镇静BCS(Bruggrmann Comfort Scale)舒适评分,术后8 h(T_(2))、12 h(T_(3))、24 h(T_(4))、48 h(T_(5))的炎性因子水平,以及不良反应发生情况。结果A组的术后镇痛泵按压次数、麻醉药物用量、不良反应发生率均显著低于B组,且A组术后T_(2)、T_(3)、T_(4)、T_(5)的炎性因子水平以及VAS评分均显著低于B组(P<0.05),BCS评分显著高于B组(P<0.05)。结论腰椎融合术中采用盐酸氢吗啡酮超前镇痛,可减少术中全麻药物的用量,改善患者术后早期镇痛效果,减轻炎症反应,减少术后并发症,促进快速康复。

Objective To evaluate the effects of hydromorphone hydrochloride on postoperative analgesia and inflammatory cytokine levels during lumbar fusion.Methods Forty patients undergoing lumbar fusion were randomly divided into hydromorphone hydrochloride group(group A)and control group(group B),with 20 patients in each group.The operation status of the two groups of patients was recorded,as well as VAS and BCS(Bruggrmann Comfort Scale)scores aT 2h(T_(1)),8 h(T_(2)),12 h(T_(3)),24 h(T_(4)),48 h(T_(5))after operation,inflammatory cytokine levels at 8 h(T_(2)),12 h(T_(3)),24 h(T_(4)),48 h(T_(5))after operation,and the occurrence of adverse reactions was also recorded.Results The number of postoperative analgesic pump presses,dosage of anesthesia drugs,incidence of adverse reaction in group A were lower than those in group B,and the inflammatory cytokine levels of T_(2),T_(3),T_(4)and T_(5),VAS in group A were lower than those in group B(P<0.05),while the BCS scores were higher than those in group B(P<0.05).Conclusion The advanced analgesia method of hydromorphone hydrochloride during lumbar fusion can reduce the general anesthesia drug dosage,the inflammatory cytokine levels,and improve the effect of early postoperative analgesia and prognosis of patients,thereby reducing postoperative complications and promoting rapid recover.