| Objective:Sufentanil is an opioid drug with the strongest analgesic effect,which is widely used in the analgesic treatment of Orthopaedic Surgery,but there is no clear study on whether sufentanil will affect the healing process of fracture.In this experiment,sufentanil citrate injection was injected intraperitoneally into the tibial fracture rats in the experimental group,and compared with the tibial fracture rats in the control group injected intraperitoneally with the same amount of normal saline,To investigate the effect of sufentanil on bone healing after fracture surgery in rats with tibial fracture.Methods:48 male SD rats aged 6 weeks and weighing 200 ± 25 g were selected.After intraperitoneal injection of 7% chloral hydrate at 0.5ml/100 g,a transverse fracture was made at the middle and lower third of the tibia of the right leg.A 0.8mm Kirschner wire was used to penetrate into the medullary cavity from the tibial plateau.After manual reduction,it was retrogradely penetrated into the distal end of the fracture and fixed to prepare the rat tibial fracture model.48 SD rats after fracture were randomly divided into experimental group(intraperitoneal injection of sufentanil 10 ug / kg,diluted 0.5ml)and control group(intraperitoneal injection of 0.9% normal saline 0.5ml),with 24 rats in each group.They were administered at 8 a.m.and 20 p.m.every day from the first day after operation,with an interval of 12 hours,twice a day.On the 7th,14 th and 28 th day after operation,8 rats were randomly selected from the experimental group and the control group.After intraperitoneal injection of chloral hydrate,the carotid artery was catheterized to take the arterial blood.The blood was centrifuged and the upper serum was stored in the refrigerator at-20 ℃.Then the rats were killed.The right lower limb of the rats was taken off and X-ray films were taken to observe the healing degree of tibial fracture.After taking the X-ray film,remove the right tibia of the rat,remove the clean muscle and soft tissue,fix it with 4% paraformaldehyde fixation solution for 24 hours,and then decalcify it with EDTA decalcification solution for 1 month.After decalcification,cut the tibial specimen with a length of 1 cm from the top and bottom of the tibial fracture.After decalcified rat tibia specimens were stained with he,the bone histomorphology and cytological characteristics of the fracture site were observed under electron microscope.The decalcified tibia specimens were stained by immunohistochemistry,and the expression level of bone morphogenetic protein-2(BMP-2)was detected under electron microscope.After thawing the collected rat serum,the alkaline phosphatase(ALP)and transforming growth factor in serum were detected by ELISA kit β 1(TGF-β 1)Level.Results:(1)The results of X-ray film showed that at 1 week after operation,the fracture line of the fracture end in the experimental group was clear,while the fracture end in the control group was slightly blurred;At 2 weeks after operation,the fracture line of the fracture end in the experimental group was clear,while the fracture line in the control group was fuzzy;At 4 weeks after operation,the fracture line could still be seen at the fracture end of the rats in the experimental group,while the fracture line of the fracture end of the rats in the control group disappeared completely.(2)He staining showed that the number of new bone cells,new blood vessels and new bone trabeculae in the experimental group were lower than those in the control group at 1,2 and 4 weeks after tibial fracture surgery.(3)The content of serum alkaline phosphatase in the experimental group and the control group began to rise at 1 week,the highest at 2 weeks and gradually decreased at 4 weeks.The content of serum alkaline phosphatase in the experimental group was lower than that in the control group at 1,2 and 4 weeks after operation.The results were statistically significant(P < 0.05).(4)Serum transforming growth factor in experimental group and control group β The content of TGF-1 increased continuously at1 week,2 weeks and 4 weeks after operation,and the serum transforming growth factor of rats in the experimental group β The content of 1 in each period was lower than that in the control group,and the result was statistically significant(P <0.05).(5)The expression level of bone morphogenetic protein 2 in the bone tissue of the fracture site of the experimental group was lower than that of the control group at 1,2 and 4 weeks after operation(P < 0.05).Conclusion:At 1,2 and 4 weeks after operation,the fracture healing degree of tibial fracture rats in the experimental group treated with sufentanil was significantly lower than that in the control group in X-ray imaging and he staining histomorphology.At 1,2 and 4 weeks,the serum ALP content and serum TGF of tibial fracture rats in the experimental group treated with sufentanil-β The content of BMP-1 and the expression level of BMP-2 in bone tissue were lower than those in the control group.The results were statistically significant.Therefore,this experiment confirmed that sufentanil can inhibit the fracture healing of tibial fracture rats,and should be carefully used in the analgesic treatment of elderly patients,osteoporosis patients and other patients prone to delayed fracture healing or nonunion. |
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