Effects Of Postoperative Intravenous Analgesia With Hydromorphone On Stress Response In Patients Undergoing Hip Replacement

BackgroundArtificial hip replacement is one of the treatment methods for hip joint diseases,which has the advantages of alleviating joint pain and correcting deformities.It is conducive to improvement of quality of life in patients,and has been widely applied in clinical treatment.Although hip arthroplasty can effectively reduce the incidence of postoperative complications,surgery as a traumatic operation is still difficult to avoid causing considerable pain and adverse reactions in patients,which hinders the recovery of postoperative joint function,Will also increase the incidence of complications such as increased blood pressure and blood pressure,increased heart rate.Therefore,postoperative analgesia is of great significance for patients undergoing artificial hip joint treatment.ObjectiveTo investigate the effect of hydromorphone on postoperative analgesia in patients undergoing hip arthroplasty and its effect on postoperative stress response in order to provide clinical application of hydromorphone intravenous analgesia in hip arthroplasty.MethodsA total of 93 patients who underwent artificial hip arthroplasty in our hospital from September 2018 to September 2019 were selected.According to the inclusion and exclusion criteria,13 patients were excluded.Actually,80 patients who underwent hip replacement surgery were included in this study.The subjects were divided into control group(n = 36 cases)and observation group(n = 44 cases)according to the random number table method.Both groups of patients underwent unilateral hip arthroplasty and patient-controlled intravenous analgesia(PCIA).In the control group,2 mg of tropanetronwas intravenously injected during the suture of the skin and connected with sufentanil 2 μg/ kg + saline to 100 m L Self-controlled analgesic pump for medicinal solution.Patients in the observation group were intravenously injected with 2 mg of tropisetron during surgical suture and connected to a self-controlled analgesic pump containing hydromorphone 0.1mg / kg + saline to 100 m L.The flow rate was 2 ml / h.The self-control volume is 0.5 ml,and the recharge time is 15 minutes.Measure the levels of hormones such as Noradrenaline(Norepinephrine),Corticotropin(Corticotropin),and VAS(Pain Vision)at different time points(1 h,12 h,24 h,36 h,48 h)after surgery Analog score).The incidence of adverse reactions within 72 hours after surgery and satisfaction with analgesia at 48 hours were compared between the two groups,and statistical analysis was performed.Results1.There was no significant difference in age,gender,ASA classification,BMI,operation time,and intraoperative blood loss between the two groups(P> 0.05).2.At 1 hour,12 hours,and 24 hours after surgery,the VAS scores of the two groups showed a gradually increasing trend,and 36 hours and 48 hours after surgery,the VAS scores of the two groups showed a downward trend;At the time point,the VAS score of the observation group was significantly lower than that of the control group,and there was a statistical difference(P <0.05).3.Noradrenaline,Cortisol,serotonin and hormones in the venous blood of the two groups of patients at 1 h,12 h,24 h,36 h,and 48 h all showed a gradual decrease.At the corresponding time point after surgery,The levels of noradrenaline,corticotropin,cortisol,serotonin and other hormones were significantly lower than those in the control group,and there was a statistical difference(P <0.05).4.In the observation group,there was 1 case of skin itching symptoms and 2 cases of nausea and vomiting symptoms;the control group showed 1 skin itching symptoms and 6cases of nausea and vomiting symptoms.In addition,there were 2 cases of respiratory depression symptoms.By calculation,the incidence of adverse reactions in the observationgroup was 6.82%,and the incidence of adverse reactions in the control group was 25.00%,which was significantly higher than that in the observation group(P <0.05).5.The postoperative analgesia satisfaction score(3.36 ± 0.61)in the observation group was significantly higher than that in the control group(3.08 ± 0.55),and there was a statistical difference(P <0.05).ConclusionsHydromorphone postoperative analgesia can effectively reduce postoperative norepinephrine,adrenocorticotropic hormone,cortisol,and serotonin levels,reduce the body’s stress response,and reduce the incidence of postoperative analgesic adverse reactions.It can be used as a hip joint Postoperative pain medication for patients undergoing replacement surgery.