羟考酮对肱骨骨折术后镇痛的影响

发布时间：2018-06-19 12:37

本文选题：羟考酮 + 术后镇痛　；参考：《临床麻醉学杂志》2015年05期

【摘要】：目的观察羟考酮对肱骨骨折术后镇痛的影响。方法择期喉罩插管全麻复合臂丛阻滞麻醉下肱骨骨折切开复位内固定术患者60例,男46例,女14例,随机均分为羟考酮组(O组)和吗啡组(M组)。分别于麻醉前(T0)、术后1h(T1)、3h(T2)、24h(T3)和48h(T4)抽取外周静脉血,应用酶联免疫吸附试验(ELISA)检测血清IL-2水平,记录MAP、SpO2、VAS评分及不良反应。结果与T0时比较,T2~T4时O组血清IL-2水平明显升高(P0.05),而T1、T2、T4时M组血清IL-2水平明显降低(P0.05)。与M组比较,T2~T4时O组血清IL-2水平明显升高(P0.05)。两组MAP、SpO2和VAS评分和不良反应差异均无统计学意义。结论吗啡、羟考酮均可有效减轻术后疼痛。与吗啡抑制IL-2分泌相反,羟考酮可明显增加肱骨内固定手术患者术后IL-2的分泌。
[Abstract]:Objective to observe the effect of hydroxycodone on postoperative analgesia of humeral fracture. Methods Sixty patients (46 males and 14 females) with open reduction and internal fixation of humeral fractures under selective laryngeal mask intubation combined with brachial plexus block anesthesia were randomly divided into hydroxycodone group (n = 14) and morphine group (n = 14). Peripheral venous blood was collected before anesthesia, 1 hour after operation, 24 hours after operation, and 48 hours after operation. The level of serum IL-2 was detected by enzyme linked immunosorbent assay (Elisa), and the scores of MAPSpO2VAS and adverse reactions were recorded. Results compared with T0, the level of serum IL-2 in group O was significantly higher than that in group T0, while that in group M at T0 and T4 was significantly lower than that in group M. Compared with group M, serum IL-2 level in group O was significantly higher than that in group M (P 0.05). There was no significant difference in MAPO 2 and VAS scores and adverse reactions between the two groups. Conclusion morphine and hydroxycodone can effectively relieve postoperative pain. In contrast to morphine inhibiting IL-2 secretion, hydroxycodone significantly increased IL-2 secretion after humeral internal fixation.
【作者单位】：江苏省盐城市第一人民医院麻醉科;
【分类号】：R614

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