右美托咪定联合超声引导神经阻滞对髋部骨折合并糖尿病患者术后镇痛 效果、免疫应激和疼痛介质的影响.

Objective: To observe the effects of dexmedetomidine combined with ultrasound-guided nerve block on postoperative analgesia, immune stress and pain mediators in patients with hip fracture complicated with diabetes. Methods: 120 patients with hip fracture complicated with diabetes who were admitted to our hospital from June 2020 to June 2023 were divided into control group 60 cases (ultrasound-guided nerve block) and study group 60 cases (dexmedetomidine combined with ultrasound-guided nerve block) according to the random number table method. Postoperative patient-controlled intravenous analgesia (PCIA) was performed in both groups. The sedation, analgesia, PCIA pressing times, immune function, stress response and pain mediators were compared between two groups, and the occurrence of adverse reactions during the treatment was observed. Results: 12 h, 24 h and 48 h after operation, the visual analogue scale (VAS) score in study group was lower than that in control group, and the Ramsay sedation score was higher than that in control group (P＜0.05). The number of PCIA compressions in study group was less than that in control group (P＜0.05). 1 d after operation,CD3+, CD4+, CD4+/CD8+ in study group were higher than those in control group, and cortisol (Cor), norepinephrine (NE), prostaglandin E2 (PGE2), epinephrine (E), calcitonin gene-related peptide (CGRP), substance P (SP) and CD8+were lower than those in control group (P＜0.05). In terms of incidence of adverse reactions, there was no difference observed between the two groups in comparison (P＞0.05). Conclusion: Ultrasound-guided nerve block combined with dexmedetomidine in patients with hip fracture and diabetes, which can exert good sedative and analgesic effects, reduce immunosuppression and postoperative pain. [ABSTRACT FROM AUTHOR]