Effect of different analgesic modes on postoperative analgesia in patients with oral cancer
Objective To examine the influence of different analgesic modes on postoperative analgesia in patients with oral cancer.Methods A total of 78 patients with oral cancer in The First Affiliated Hospital of Harbin Medical University from October 2021 to December 2022 were selected and divided into two groups(group A and group B)according to random number table method,with 39 cases in each group.Group A was divided into group A1(advanced an-algesia+postoperative analgesia,n=20)and group A2(postoperative analgesia,n=19),group B was divided into group B1(advanced analgesia+postoperative analgesia+local anes-thesia,n=22)and group B2(postoperative analgesia+local anesthesia,n=17).Vital signs,visual analogue scale(VAS)and serum white blood cell(WBC),glucose(Glu),C-re-active protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels were compared in the four groups at each time point during perioperative period.Results There was no significant difference in heart rate(HR)and mean arterial pressure(MAP)between 4 groups at the stage of invasion(T0)(P＞0.05).Immediately after endotracheal intubation(T1),immediately after extubation(T2),5 minutes after extubation(T3),HR and MAP levels in 4 groups were increased compared with T0(P＜0.05);MAP at T2,A2＞A1,B1,B2＞B1,P＜0.05;Heart rate at T1,A2,B2＞A1 and B1;at T2,A2,B2＞A1 and B1;at T3,A2,B2＞A1 and B1,P＜0.05;VAS score 1 h after surgery,B1＜A1＜B2＜A2 group;At 6 h after operation,B1＜A1,B2＜A2;24 h after surgery,B1＜A1,B2＜A2,P＜0.05;There was no significant difference in the levels of WBC,Glu,CRP,IL-6 and TNF-α at T0 time point(P＞0.05).Blood glucose in 1 h postoperatively,B1＜A1,B2＜A2;6 h postop-eratively,B1＜A1,B2＜A2;24 h postoperatively,B1＜A2,B2,A1＜A2;P＜0.05;WBC in group A2＞B2＞A1＞B1 at 1 h after surgery,group A2,B2＞A1＞B1 at6h after surgery,group A2＞B2＞A1＞B1 at 24 h after surgery,P＜0.05;The levels of CRP,IL-6 and TNF-αwere B1＜A1＜B2＜A2 group 1 h,6 h and 24 h after surgery,P＜0.05;There was no statisti-cal significance in the incidence of nausea,vomiting,pruritus,urinary retention,respiratory depression and other adverse reactions among 4 groups(P＞0.05).Conclusion The analge-sic program of advanced analgesia combined with postoperative analgesia and local anesthesia can reduce postoperative inflammation and reduce the incidence of adverse reactions,and the analgesic effect is superior to other programs.
multimodal analgesiaoral cancer surgerypain scorestress response
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