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目的:研究盐酸氢吗啡酮联合罗哌卡因用于骨科术后自控硬膜外镇痛(PCEA)的血清疼痛介质及应激反应的影响。方法:选择2012年5月~2015年12月在广东省惠州市中心人民医院接受硬腰联合麻醉下骨折手术且要求术后镇痛的84例患者,随机分为两组,观察组接受罗哌卡因配伍盐酸氢吗啡酮术后PCEA,对照组接受罗哌卡因配伍盐酸吗啡术后PCEA。比较两组患者的PCEA情况、血清疼痛介质含量以及应激反应程度。结果:观察组患者术后24h内追加按压镇痛泵的次数以及麻醉药物用量显著低于对照组;手术后1d、3d、5d时,观察组患者血清中5-HT、NO、PGE2以及Cor、GH、PRL的含量显著低于对照组;手术后1d、3d、5d、7d时,观察组患者的REE水平均显著低于对照组。结论:盐酸氢吗啡酮联合罗哌卡因用于骨科术后PCEA能够增强镇痛效果、减少麻醉药物用量并抑制疼痛介质产生、减轻应激反应。
Abstract：Objective:To study the effect of hydromorphone hydrochloride combined with ropivacaine for orthopedic postoperative patient-controlled epidural analgesia(PCEA)on serum pain mediators and stress response.Methods:A total of84 patients who received fracture surgery under combined spinal epidural anesthesia and required postoperative analgesia in our hospital from May 2012 to December 2015 were randomly divided into two groups,the observation group received ropivacaine combined with hydromorphone hydrochloride for postoperative PCEA,and the control group accepted ropivacaine combined with morphine hydrochloride for postoperative PCEA.PCEA,serum pain mediator levels and the degree of stress response were compared between two groups.Results:The number of additional pressing on analgesia pump and the dosage of anesthetics of observation group within 24 hafter operation were significantly lower than those of control group;1d,3dand 5dafter operation,serum 5-HT,NO and PGE2 as well as Cor,GH and PRL levels of observation group were significantly lower than those of control group;1d,3d,5dand 7dafter operation,REE levels of observation group were significantly lower than those of control group.Conclusions:Hydromorphone hydrochloride combined with ropivacaine for orthopedic postoperative PCEA can enhance analgesic effect,reduce the dosage of anesthetics,suppress the generation of pain mediators and reduce stress response.
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基本信息:
DOI：10.13210/j.cnki.jhmu.20160802.001
中图分类号:R614
引用信息:
[1]陈然,刘远辉,严俨,等.盐酸氢吗啡酮联合罗哌卡因用于骨科术后PCEA对血清疼痛介质及应激反应的影响[J].海南医学院学报,2016,22(21):2613-2615+2618.DOI:10.13210/j.cnki.jhmu.20160802.001.
基金信息:
广东省惠州市科技计划项目(20150809)~~
2016-08-02
2016-08-02
2016-08-02