摘要
目的:探讨罗哌卡因联合舒芬太尼在肱骨近端骨折患者连续臂丛神经阻滞(CBPB)术后的镇痛效果分析及对血清炎性因子和应激反应的影响。方法:选择我院2021年6月到2022年8月期间接收的肱骨近端骨折患者100例,根据随机数字表法分为对照组(罗哌卡因镇痛,50例)和研究组(罗哌卡因联合舒芬太尼镇痛,50例)。观察两组的镇痛效果,并对比两组血清炎性因子和应激反应的变化,记录两组不良反应发生情况。结果:研究组视觉疼痛模拟评分法(VAS)评分低于对照组,自控镇痛泵(PCA)按压次数、48 h药物总消耗量少于对照组(P<0.05)。两组术后48 h肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、IL-1、IL-2升高,但研究组低于对照组(P<0.05)。两组术后48 h儿茶酚胺(CA)、皮质醇(COR)、肾上腺素(E)升高,但研究组低于对照组(P<0.05)。两组不良反应发生率对比无差异(P>0.05)。结论:罗哌卡因联合舒芬太尼用于肱骨近端骨折患者CBPB,术后镇痛效果确切,可减轻机体应激反应,抑制炎性因子水平。
Objective:To investigate the analgesic effect analysis of ropivacaine combined with sufentanil after continuous brachial plexus block(CBPL)in patients with proximal humeral fracture and its influence on serum inflammatory factors and stress response.Methods:100 patients with proximal humeral fracture who were received in our hospital from June 2021 to August 2022 were selected,and they were divided into the control group(ropivacaine analgesia after CBPB,50 cases)and the study group(ropivacaine combined with sufentanil analgesia,50 cases)according to the random number table.The analgesic effect of the two groups was observed,and the changes of serum inflammatory factors and stress response were compared of the two groups.The occurrence of adverse reactions of the two groups was recorded.Results:The visual pain analogue scale(VAS)score of the study group was lower than that of the control group,and the pressure times of patient-controlled analgesia pump(PCA)and the total consumption of drugs in 48 hours were lower than those of the control group(P<0.05).The tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-1 and IL-2 of the two groups at 48 h after operation were significantly higher,but the study group was lower than the control group(P<0.05).The catecholamines(CA),cortisol(COR)and epinephrine(E)of the two groups at 48 h after operation were significantly higher,but the study group was lower than the control group(P<0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Ropivacaine combined with sufentanil for CBPB in patients with proximal humeral fracture has a definite postoperative analgesic effect,which can reduce the body's stress response,and inhibit the level of inflammatory factors.
作者
冯骥
税云华
张茺
向芮
张兰
FENG Ji;SHUI Yun-hua;ZHANG Chong;XIANG Rui;ZHANG Lan(Department of Anesthesiology,Sichuan Orthopedic Hospital,Chengdu,Sichuan,610031,China)
出处
《现代生物医学进展》
CAS
2023年第5期940-944,共5页
Progress in Modern Biomedicine
基金
四川省医学科研青年创新项目(Q18855)。
关键词
肱骨近端骨折
连续臂丛神经阻滞
舒芬太尼
罗哌卡因
术后镇痛
炎性因子
应激反应
Proximal humeral fracture
Continuous brachial plexus block
Sufentanil
Ropivacaine
Postoperative analgesia
Inflammatoryfactors
Stressresponse
