右美托咪定联合地佐辛超前镇痛在下肢骨折患者术后镇痛和应激反应的影响

Effect of Dexmedetomidine Combined with Dezocine on Postoperative An⁃algesia and Stress Response in Patients with Lower Extremity Fracture

目的探讨右美托咪定联合地佐辛超前镇痛在下肢骨折患者手术后镇痛和应激反应中的影响。方法选取2021年7月—2022年9月扬州市江都中医院收治的80例下肢骨折手术患者为研究对象,按随机数表法分成对照组和研究组,每组40例。对照组采取地佐辛超前镇痛,研究组则采取右美托咪定+地佐辛超前镇痛。对比两组患者手术后不同时间段中疼痛程度和应激反应以及不良反应发生情况。结果术后,研究组8、12、24 h疼痛程度评分(5.14±1.05)分、(4.25±1.09)分、(2.77±0.58)分,均低于对照组,差异有统计学意义(t=7.590、9.168、13.986,P均<0.05);术前,两组患者皮质醇和肾上腺素比较,差异无统计学意义(P均>0.05);术后,研究组皮质醇水平与肾上腺素水平均低于对照组,差异有统计学意义(P均<0.05);研究组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论将右美托咪定与地佐辛超前镇痛进行联合使用,可以显著降低下肢骨折患者术后的疼痛感,并将其应激反应进行降低,安全性更高,对患者血流动力学影响更小。

Objective To investigate the influence of dexmedetomidine combined with dezocine on analgesia and stress response in patients with lower extremity fracture after operation.Methods A total of 80 patients with lower limb fracture surgery admitted to Jiangdu Hospital of Traditional Chinese Medicine of Yangzhou City from July 2021 to September 2022 were selected as the study objects,and were divided into control group and study group according to random number table method,with 40 cases in each group.The control group received desocine preanalgesia,and the study group received dexmedetomidine+desocine preanalgesia.The pain degree in different time periods after op⁃eration,stress response and adverse reactions were compared between the two groups.Results After operation,the pain degree scores of the study group at 8,12,24 h were(5.14±1.05)points,(4.25±1.09)points and(2.77±0.58)points,which were lower than those of the control group,and the differences were statistically significant(t=7.590,9.168,13.986,all P<0.05).Before operation,there was no significant difference in cortisol and epinephrine between the two groups(both P>0.05).After operation,cortisol and adrenaline levels in the study group were lower than those in the control group,and the differences were statistically significant(both P<0.05).The incidence of adverse reac⁃tions in study group was lower than that in control group,and the difference was statistically significant(P<0.05).Conclusion The combination of dexmedetomidine and dezocine for advanced analgesia can significantly reduce post⁃operative pain in patients with lower extremity fracture,and reduce their stress response,with higher safety and less impact on patients'hemodynamics.