Advance Search
HUA Jun, TANG Yanbin, LIU Yufang, TANG Lifei, LIAO Xingzhi. Analgesic effect of epidural injection of hydromorphone combined with dexmedetomidine in elderly patients after total hip replacement[J]. Journal of Clinical Medicine in Practice, 2021, 25(8): 101-104, 108. DOI: 10.7619/jcmp.20210221
Citation: HUA Jun, TANG Yanbin, LIU Yufang, TANG Lifei, LIAO Xingzhi. Analgesic effect of epidural injection of hydromorphone combined with dexmedetomidine in elderly patients after total hip replacement[J]. Journal of Clinical Medicine in Practice, 2021, 25(8): 101-104, 108. DOI: 10.7619/jcmp.20210221
shu

Analgesic effect of epidural injection of hydromorphone combined with dexmedetomidine in elderly patients after total hip replacement

  • Department of Anesthesiology, The 904 Hospital of the Joint Logistic Support Force of People's Liberation Army, Wuxi, Jiangsu, 214000

More Information
  • Received Date: February 02, 2021
  • Available Online: April 29, 2021
  • Published Date: April 27, 2021
    Graphical Abstract
    • Abstract
  •   Objective  To observe the analgesic effect of epidural injection of hydromorphone combined with dexmedetomidine in elderly patients after total hip arthroplasty.
      Methods  Seventy-eight patients undergoing total hip arthroplasty were randomly divided into study group and control group, with 39 cases in each group. The control group was given epidural injection of 0.3 mg hydromorphone after the operation, and the study group was sequentially injected with dexmedetomidine 0.5 μg/kg and hydromorphone 0.3 mg. Intravenous controlled analgesia by sufentanil was used in both groups. At 1, 4, 12, 24 h (T1, T2, T3, T4) after operation, Visual Analogue Scale(VAS) scores, Ramsay sedation score, heart rate (HR), mean arterial pressure (MAP) and blood oxygen saturation (SpO2) of the two groups were compared. The sufentanil consumption dosage and adverse reactions were recorded.
      Results  The VAS scores and Ramsay scores at T3 and T4 of the study group were significantly lower than those of the control group at rest and exercise (P < 0.05). The Ramsay score at T4 of the study group was significantly lower than that of T1 (P < 0.05). HR at T2 to T4 and MAP at T1 to T3 in the study group were significantly lower than those in the control group (P < 0.05). Compared with T1, the study group had decreased HR at T2 to T4, and the control group had decreased MAP at T2 to T4 (P < 0.05). The consumption of sufentanil in the study group was significantly less than that in the control group (P < 0.05). There was no difference in adverse reactions between the two groups (P>0.05).
      Conclusion  The epidural injection of hydromorphone combined with dexmedetomidine has a significant analgesic effect after total hip arthroplasty in the elderly, and has the functions of stabilizing hemodynamics and benefiting postoperative recovery.
    • FullText(HTML)
    • References (18)
  • [1]
    HU X Y, HOU P F, LI T T, et al. The roles of wnt/βcatenin signaling pathway relatedlncRNAs in cancer[J]. Int J Biol Sci, 2018, 14(14): 2003-2011. doi: 10.7150/ijbs.27977
    [2]
    LEE M W, LIM H K. Management of subcentimeter recurrent the hepatocellular carcinoma after curative treatment: current statusand future[J]. World J Gastroenterol, 2018, 24(46): 52155222. http://kns.cnki.net/KCMS/detail/detail.aspx?dbcode=CJFD&filename=ZXXY201846003
    [3]
    ZHAO X, SUN B, LIU T, et al. Long noncoding RNA n339260 promotesvasculogenic mimicry and cancer stem cell development in hepatocellular carcinoma[J]. Cancer Sci, 2018, 109(10): 3197-3208. doi: 10.1111/cas.13740
    [4]
    HIREN S R, VIJAY N S, JAYWANT S K. Comparison of visual analogue scale (VAS) and the Nasal Obstruction Symptom Evaluation (NOSE) score in evaluation of post septoplasty patients[J]. World J Otorhinolaryngol Head Neck Surg, 2020, 6(1): 53-58. doi: 10.1016/j.wjorl.2019.06.002
    [5]
    王国林, 郭曲练. 麻醉学[M]. 北京: 清华大学出版社, 2015: 25-26.
    [6]
    BHATIA N, MEHTA S, SAINI V, et al. Comparison of intraperitoneal nebulization of ropivacaine with ropivacaine-fentanyl combination for pain control following laparoscopic cholecystectomy: a randomized, double-blind, placebo-controlled trial[J]. J Laparoendosc Adv Surg Tech Part A, 2018, 28(7): 839-844. doi: 10.1089/lap.2017.0725
    [7]
    BHANDARI M, SWIONTKOWSKI M. Management of acute hip fracture[J]. N Engl J Med, 2017, 377(21): 2053-2062. doi: 10.1056/NEJMcp1611090
    [8]
    JØRGENSEN C C, PETERSEN M, KEHLET H, et al. Analgesic consumption trajectories in 8975 patients 1-year after fast-track total hip or knee arthroplasty[J]. Eur J Pain, 2018, 22(8): 1428-1438. doi: 10.1002/ejp.1232
    [9]
    STEENBERG J, MØLLER A M. Systematic review-effects of fascia iliaca compartment block on hip fractures before operation[J]. Br J Anaesth, 2018, 120(6): 1368-1380. doi: 10.1016/j.bja.2017.12.042
    [10]
    MEI B, MENG G, XU G, et al. Intraoperative sedation with dexmedetomidine is superior to propofol for elderly patients undergoing hip arthroplasty: a prospective randomized controlled study[J]. Clin J Pain, 2018, 34(9): 811-817. doi: 10.1097/AJP.0000000000000605
    [11]
    JANTZEN C, MADSEN C M, LAURITZEN J B, et al. Temporal trends in hip fracture incidence, mortality, and morbidity in Denmark from 1999 to 2012[J]. Acta Orthop, 2018, 89(2): 170-176. doi: 10.1080/17453674.2018.1428436
    [12]
    SIMON B T, SCALLAN E M, COURSEY C D, et al. The clinical effects of a low dose dexmedetomidine constant rate infusion in isoflurane anesthetized cats[J]. Vet J, 2018, 234: 55-60. doi: 10.1016/j.tvjl.2018.02.008
    [13]
    SAYED J A, ABD ELSHAFY S K, KAMEL E Z, et al. The impact of caudally administered tramadol on immune response and analgesic efficacy for pediatric patients: a comparative randomized clinical trial[J]. Korean J Pain, 2018, 31(3): 206-214. doi: 10.3344/kjp.2018.31.3.206
    [14]
    马立刚, 赵晶晶. 右美托嘧啶对乳腺癌根治术患者镇痛及血流动力学稳定性分析[J]. 实用癌症杂志, 2018, 33(11): 1853-1856. https://www.cnki.com.cn/Article/CJFDTOTAL-SYAZ201811033.htm
    [15]
    SHIN H J, DO S H, LEE J S, et al. Comparison of intraoperative sedation with dexmedetomidine versus propofol on acute postoperative pain in total knee arthroplasty under spinal anesthesia: a randomized trial[J]. Anesth Analg, 2019, 129(6): 1512-1518. doi: 10.1213/ANE.0000000000003315
    [16]
    KLUKOWSKI M, KOWALCZYK R, GÓRNIEWSKI G, et al. Iliac fascia compartment block and analgesic consumption in patients operated on for hip fracture[J]. Ortopedia Traumatol Rehabilitacja, 2017, 19(5): 451-459. http://europepmc.org/abstract/MED/29154229
    [17]
    乔克坤, 李向. 右美托嘧啶对老年腹腔镜胆囊切除术患者麻醉效果及认知功能的影响[J]. 中国药物警戒, 2020, 17(2): 81-86. https://www.cnki.com.cn/Article/CJFDTOTAL-YWJJ202002004.htm
    [18]
    谢淑华, 杨涛, 魏斐, 等. 右美托咪定或羟考酮复合罗哌卡因连续股神经阻滞用于全膝关节置换术后镇痛的效果[J]. 临床麻醉学杂志, 2019, 35(8): 733-737. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201908001.htm
    • Related Articles

  • Related Articles

    [1]XIONG Yongqun, HE Yushen, XIE Peiwen, ZHENG Yi, LIN Jianwei, LI Yuancun, ZHANG Guihua. Sensitivity and specificity of fundus photograph in detecting diabetic macular edema[J]. Journal of Clinical Medicine in Practice, 2023, 27(18): 44-48. DOI: 10.7619/jcmp.20232028
    [2]WANG Xiaoli, QU Hang, CHENG Weiyan, ZHAO Yi, CAI Yujian, WANG Wei. Application value of X-ray radiomics in distinguishing benign and malignant breast lesions and the efficacy comparison of three predictive models[J]. Journal of Clinical Medicine in Practice, 2021, 25(8): 21-24. DOI: 10.7619/jcmp.20210555
    [3]WANG Ying, LIU Min. Value of video electroencephalogram combined with neuron specific enolase detection in the diagnosis of children with febrile convulsions[J]. Journal of Clinical Medicine in Practice, 2020, 24(9): 10-12. DOI: 10.7619/jcmp.202009003
    [4]WANG Dan, CHEN Gengwu. Accuracy of morphology of gastric mucosa by gastroscopy in the judgment of Helicobacter pylori infection[J]. Journal of Clinical Medicine in Practice, 2020, 24(4): 87-89. DOI: 10.7619/jcmp.202004022
    [5]YIN Jiansong, XUE Mei, WANG Jing, LIU Caixia, WAN Yu. Diagnostic value of oxygen saturation monitoring combined with auscultation murmur detection in congenital heart disease[J]. Journal of Clinical Medicine in Practice, 2020, 24(3): 78-80. DOI: 10.7619/jcmp.202003022
    [6]JIANG Guoliang, WU Xiaojun. CT plain scan versus enhanced scan in the diagnosisof blunt abdominal trauma[J]. Journal of Clinical Medicine in Practice, 2019, 23(18): 22-24. DOI: 10.7619/jcmp.201918007
    [7]WANG Song. Value of coronary CT angiography in the diagnosisof plaque characteristics in patients with acute coronary syndrome[J]. Journal of Clinical Medicine in Practice, 2019, 23(17): 42-44. DOI: 10.7619/jcmp.201917012
    [8]MA Tianming, HAN Xianwei. Change and significance of serum neuron specific enolase level in patients with herpes zoster[J]. Journal of Clinical Medicine in Practice, 2017, (13): 100-102. DOI: 10.7619/jcmp.201713026
    [10]LIU Chunxia, GU Meng, ZHANG Hong, HANG Gao. Detection of specific allergen in allergic children in Nantong region and its clinical significance[J]. Journal of Clinical Medicine in Practice, 2014, (9): 44-47. DOI: 10.7619/jcmp.201409012

  • Cited by

    Periodical cited type(11)

    1. 涂兵英，涂腾兵，吴莉娅，杨柳青. 风险管理在消毒供应中心外来医疗器械管理中的应用效果. 医疗装备. 2022(01): 64-66 .
    2. 卫妍. 信息追溯系统在腔镜器械消毒管理中的应用. 西藏医药. 2022(01): 8-9 .
    3. 江莉娟，卢又虹，钟晓敏. 建立sop对提高管腔器械清洗质量中应用. 中国医疗器械信息. 2022(18): 161-163 .
    4. 杨晨希. 硬式内窥镜的清洗消毒灭菌方法探讨与标准化流程的建立. 临床医药文献电子杂志. 2020(31): 182 .
    5. 李程. 标准化流程护理措施对腹腔镜器械清洗质量及灭菌效果的影响. 吉林医学. 2020(12): 3020-3022 .
    6. 李婷婷，高兴莲，黄靖，甘琴，董琦. 品质管理联合预防性护理模式对腹腔镜妇科手术感染控制及护理质量的影响. 全科护理. 2019(19): 2383-2385 .
    7. 申梅岭. 标准化流程在医院消毒供应室器械消毒灭菌中的应用价值分析. 中国卫生产业. 2019(17): 74-75 .
    8. 王颖. 系统化护理模式对腹腔镜妇科手术感染预防的影响. 实用妇科内分泌电子杂志. 2019(27): 182 .
    9. 赖丙娇，肖婉静，黄庆英. 科室联系制度在消毒供应室质量管理中的应用效果. 护理实践与研究. 2019(21): 137-138 .
    10. 王宇徽. 标准操作程序在基层医院腔镜器械清洗消毒中的效果评价. 世界最新医学信息文摘. 2018(23): 180+189 .
    11. 齐文慧. 腹腔镜器械的清洗、消毒工作中持续质量改进管理的价值分析. 中国医疗器械信息. 2018(08): 100-101+157 .

    Other cited types(0)

Catalog

    Get Citation
    PDF
    XML
    Article views (379) PDF downloads (14) Cited by(11)
    Turn off MathJax
    Article Contents
    Abstract
    References
    Related Articles

    © 2020 《实用临床医药杂志》编辑部

    Address: 江苏省扬州市江阳中路136号，扬州大学江阳路北校区14号楼201室China Pos: 225009Tel: 0514-87978917、87978989、87978807

    苏公网安备 32100302010246号

    Supported by: Beijing Renhe Information Technology Co., Ltd.   Baidu Analytics

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return