| Objective:To observe and compare the analgesic effects of sufentanil intravenous infusion pump and bucinnazine single injection in burn patients 24 hours after scab removal and skin grafting,as well as the effects of two analgesic methods on tumor necrosis factor-?(tnf-?).Methods:From October 2017 to March 2018,40 patients who underwent surgical treatment in the burn department of Changchun Burn Hospital were selected as the study.Of these,27 male,13 female,16-65 years old,ASA ? ~ ?.Exclusion criteria for abuse or frequently take painkillers,cognitive dysfunction,allergies to opioids,ASA rating>III level,burn TBSA > 30% patients who compound one of the above standards was excluded from this study,All patients were randomly divided into two groups: Shufentanil group(S group)and bucinnazine group(B group),there was no difference in sex composition,age,burn area and skin graft area between the two groups(p>0.05).The patients in both groups were treated with skin grafting after the burn condition was stable.General anesthesia was performed by intravenous anesthesia combined with inhalation.Waiting for the patient to be fully awake and extubation.Back to the ward for analgesia,The analgesic effect of bucinnazine or sufentanil was randomly selected,The use of sufentanil was as follows: sufentanil 2?g/kg,remosetron hydrochloride 0.3mg,0.9% normal saline,was prepared into 100 ml injection vein painkiller pump.The method of the useing bucinnazine is to inject 100 mg of subcutaneous injection at least for 6 hours,and can be used repeatedly.The vas scores were recorded before operation and at 30 min,1 h,4 h,6 h,12 h and 24 h after analgesia in the two groups.The incidence of adverse reactions,such as dizziness,nausea and vomiting,skin pruritus,respiratory inhibition,urine retention,yellow vision,general anaesthesia and so on,were observed in the two groups.Venous blood samples were collected before operation and 1 h,12 h,and 24 h after operation,and the levels of tnf-? were measured by chemiluminescent method.Result:1.Analgesic effect There was no significant difference in vas score before analgesia between sufentanil group and bucinnazine group(p > 0.05).After the beginning of analgesia,the vas score of 30 min bucinnazine group was lower than that of sufentanil group(p < 0.05).After analgesia,the vas score of 1h.4h.6h.12 h.24h sufentanil group was lower than that of bucinnazine group(p < 0.05).The effect of bucinnazine group is faster than that of sufentanil group,With the prolongation of analgesic effect,the analgesic effect of sufentanil group was stronger than that of bucinnazine group.2.Untoward effect There was no significant difference in adverse reactions between the two groups.3.TNF-? level There was no significant difference in preoperative tnf-? level between sufentanil group and bucinnazine group(p > 0.05).There was no significant difference in tnf-? level between sufentanil group and bucinnazine group 1 h after operation(p > 0.05).As time goes on,At 12 h and 24 h after operation,the levels of tnf-? in sufentanil group and bucinnazine group were significantly different from that of before operation,The level of tnf-? was lower than that before operation(p < 0.05).There was no significant difference in tnf-? level between sufentanil group and bucinnazine group at different time points(p > 0.05).Conclusion:1.The effect of single subcutaneous injection of bucinnazine was faster than that of sufentanil intravenous infusion pump,but with the prolongation of time,the analgesic effect of sufentanil intravenous infusion pump was stronger than that of bucinnaizine group,and the maintenance time was long,the concentration was constant,and the operation was convenient.2.Although sufentanil and bucinnazine improved the inflammatory stress response to a certain extent,the main manifestation was the level of TNF-?,which was significantly lower than that before operation ?However,there was no significant difference in TNF-? level between the two groups. |
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