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AIM: To explore the effects of preoperative application of dezocine patient-controlled analgesia pump on stress response and cognitive function in elderly patients with lower extremity fractures. METHODS: A total of 80 elderly patients with lower extremity fractures who were treated from November 2018 to June 2020 were selected and randomly divided into a control group and a study group, 40 cases in each. The control group was not given a patient-controlled analgesia pump before anesthesia, and the study group was given intravenous analgesia with a dezocine patient-controlled analgesia pump before surgery. The postoperative stress response, cognitive function and safety were compared between the two groups.RESULTS: There were no significant differences in cognitive function MMSE score, stress response index (cortisol, epinephrine) levels, and inflammatory factors (IL-6, TNF-α) levels between the two groups before intervention (P>0.05). Compared with the indexes after operation, the MMSE scores of the study group at 12 h, 24 h and 3 days after operation were higher than those in the control group (P<0.05); The levels of cortisol, epinephrine, IL-6 and TNF-α in the study group were lower than those in the control group at 12 h and 24 h after operation (P<0.05); At the same time, the incidences of respiratory depression, urinary retention and nausea and vomiting in the study group were significantly lower than those in the control group (P<0.05).CONCLUSION: Preoperative application of dezocine patient-controlled analgesia pump in elderly patients with lower extremity fracture can significantly reduce postoperative stress response, reduce inflammatory response, and improve postoperative cognitive function, which is worthy of clinical application.
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Objective: To discuss the conversion coefficient of morphine injection with continuous intravenous pump delivery or subcutaneous injection for the patients with advanced cancer pain demanding high dose of opioids.Methods: Using a retrospective survey, the patients with advanced cancer pain demanding high dose of opioids with poor efficacy were divided into 3∶1 group and 2.5∶1 group, and the conversion coefficient of 3∶1 or 2.5∶1 was used for the opioids equivalently conversed to intravenous or subcutaneous injection of morphine.After the conversion, the degree of pain relief, the analgesic efficiency in the conversion process, titration time, daily oral morphine equivalent amount at stable pain, morphine related adverse reactions and the other indicators were studied to evaluate the analgesic effect of morphine injection with different conversion coefficient.Results: There was no statistical significant difference between the two groups in the degree of pain relief, the effective rate of analgesia and the daily oral akministration amount of morphine at sable pain(P>0.05).The adjustment times for morphine in the two groups was (1.57±0.93) and (1.0±0.00), respectively, and the difference was statistically significant (P0.05).Conclusion: Giving morphine injection to the patients with terminal cancer pain demanding high dose of opioids with poor effect, the use of PCA pump through intravenous or subcutaneous injection can effectively relieve pain.Using the conversion coefficient of 2.5:1 can quickly complete the titration process, and safely achieve the effective analgesia.
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Hydromorphone(HM),appeared in the Chinese market in 2013 is a more potent opioid analgesic than morphine and is used for moderate to severe pain. Micro-invasive drug administration methods,including continuous infusion and patientcon?trolled analgesia(PCA),will provide hopes for controlling the outbreak of pain and improving patients' satisfaction. At present ,hydro?morphone is the most commonly used drug for the treatment of acute pain,chronic pain and cancer pain. However,we should also con?sider the stability and compatibility of hydromorphone in the implantable infusion system that is most commonly used in these patients. The purpose of this paper is to review the clinical application and stability(changes in color,pH and concentration)of hydromor?phone in different infusion systems so as to provide the basis of rational clinical application.
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Hydromorphone (HM), appeared in the Chinese market in 2013 is a more potent opioid analgesic than morphine and is used for moderate to severe pain. Micro-invasive drug administration methods,including continuous infusion and patientcontrolled analgesia(PCA), will provide hopes for controlling the outbreak of pain and improving patients' satisfaction. At present, hydromorphone is the most commonly used drug for the treatment of acute pain, chronic pain and cancer pain. However, we should also consider the stability and compatibility of hydromorphone in the implantable infusion system that is most commonly used in these patients. The purpose of this paper is to review the clinical application and stability (changes in color, pH and concentration) of hydromorphone in different infusion systems so as to provide the basis of rational clinical application.
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Objective To observe the curative resection of oxycodone hydrochloride controlled intravenous analgesia pump after treatment of cervical cancer (patient-controlled-intravenous analgesia, PCIA) and the adverse effect of pain.Methods March 2016 to February 2017 undergoing open radical resection of cervical cancer patients with 108 cases, were randomly divided into observation group(n=54) and control group(n=54), the observation group was given oxycodone hydrochloride injection intravenous patient-controlled analgesia pump, the control group were treated with Sufentanil Citrate Injection patient-controlled analgesia pump, anal exhaust time, contrast two groups of patients with adverse drug reactions and postoperative 6h, 12h, 24h, 48h (NRS Numeric Rating Scale, NRS) pain score.ResultsPain score: 12h observation group compared with the control group NRS pain score (P<0.05), with statistical difference, 6h, 24h, 48h time group NRS pain scores haveno statistical difference.Adverse reactions: in the observation group, 7 cases of nausea, vomiting in 6 cases, 2 cases of hypotension;control group 16 cases of nausea and vomiting in 14 cases, 1 cases of hypotension, 1 cases of skin allergy, 1 cases of dizziness, adverse reaction rates were significantly higher than the observation group (P<0.05), the difference was statistically significant.Exhaust time: observation group (2.93±0.63) days, the control group (2.76±0.61) days, no statistical significance.ConclusionOxycodone controlled intravenous analgesia pump for analgesia in patients with radical resection of cervical carcinoma after open surgery, with less adverse reactions.
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Objective:To study the effect of comfort care to alleviate postoperative pain of tibial eminence fracture by fixation. Methods:55 patients with tibial eminence fracture between Apr 2013 and Mar 2015 in our hospital were selected and divided into observation group with 26 patients and control group with 29 cases according to the nursing methods. The control group was given the orthopaedic routine nursing method, and the observation group was given the comfortable nursing method to compare two groups of patients with postoperative pain and psychological status before and after the intervention (HAMA anxiety score and HAMD depression scale). Results:There were significant differences between two groups of patients with pain score after the intervention (t=9.545, P<0.05), and HAMA and HAMD scores decline. HAMA and HAMD scores in the observation group were significantly lower than that in the control group (t=11.593, t=10.628;P<0.05). Conclusion:Comfort care can significantly relieve postoperative pain of the tibial condyle spine fractures and improve postoperative anxiety and depression. It has good clinical application value.
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Objective To observe the clinical efficacy of auricular point sticking plus moxibustion at Zusanli (ST 36) in preventing spleen-stomach disharmony due to intravenous analgesia pump.Method Totally 120 post-operation patients with intravenous analgesia pump were randomized into a treatment group and a control group, 60 in each group. Patients in the control group were asked to take a semireclining position, and to turn over the body and do morning exercise under assistance. In addition to the intervention given to the control group, the treatment group received auricular point sticking plus moxibustion at Zusanli (ST 36). The occurrence rate of post-operation nausea, vomiting and abdominal bloating was observed.Result The occurrence rate of nausea, vomiting and abdominal bloating was 11.7% in the treatment group, versus 33.3% in the control group, and the difference was statistically significant (P<0.05).Conclusion Auricular point sticking plus moxibustion at Zusanli (ST 36) is effective in preventing spleen-stomach disharmony due to intravenous analgesia pump, and can reduce pain and complications.