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| Application of Patient-controlled Hydromorphone Analgesia in Elderly Patients with Esophageal Cancer after Thoracotomy |
| GAO Min, LIU Wen-xiong, NING Jun-ping |
| Department of Anesthesiology, Xi'an Electric Power Group Hospital, Shaanxi 710077 |
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Abstract 【Objective】To explore the application value of patient-controlled hydromorphone analgesia in elderly patients with esophageal cancer after thoracotomy. 【Methods】Eighty-two cases of elderly patients with esophageal cancer who underwent elective thoracotomy were studied. According to the random number table method, the patients were divided into the control group and the observation group, with 41 cases in each. The control group was given routine patient-controlled intravenous analgesia, while the observation group was given patient-controlled epidural hydromorphone analgesia. The changes of T lymphocytes (Th1 and Th2) in the two groups were measured. Changes of Cor, GSH-Px, Cu-Zn SOD and other stress indexes in the two groups before and after operation were recorded. The pain and sedation degree in the two groups were evaluated by VAS and Ramsay scale 4h, 8h, 12h, 24h and 48h after operation. The incidence rates of adverse reactions in the two groups were recorded. 【Results】 ① After operation, Th1 in the two groups decreased, while Th2 increased. Compared to those before operation, the differences were statistically significant (P<0.05). The decreasing range of Th1 in observation group was lower than that in the control group, and the increasing range of Th2 was also lower than that in the control group (P<0.05). ②After operation, Cor in the two groups were increased, while GSH-PX and Cu-Zn SOD were decreased. Compared to those before operation, the differences were statistically significant (P<0.05). The varied ranges of indexes in the observation group were lower than those in the control group (P<0.05). ③ Compared to postoperative 4h, VAS scores of the two groups were decreased (P<0.05). The VAS scores in different periods were lower than those of the control group (P<0.05). ④Compared to postoperative 4h, the Ramsay scores of the two groups were decreased (P<0.05). The Ramsay scores of the observation group in postoperative 4h and 8h were lower than those of the control group (P<0.05). There was no significant difference between the two groups in the scores at other time periods (P>0.05). ⑤ The incidence rates of different adverse reactions in observation group were lower than those in the control group. However, only the difference in the incidence of respiratory inhibition was statistically significant (P<0.05). 【Conclusion】The overall analgesic effect of patient-controlled hydromorphone analgesia in elderly patients with esophageal cancer after thoracotomy is good. It can relieve pain degree of patients and the sedative effect is also good. It can narrow stress factors, and has little effect on immune regulation, with high safety.
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Received: 08 June 2016
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2016, Vol. 33 
