Comparison of Postoperative Analgesia Between Bupivacaine Liposome and Bupivacaine Hydrochloride Local Anesthesia in Elderly Patients Undergoing Cardiac Surgery with Median Sternal Incision
Objective To compare the postoperative analgesic effects of liposome bupivacaine(LB)and bupivacaine hydrochloride(BH)local anesthesia in elderly patients undergoing cardiac surgery with median sternal incision.Methods All 106 elderly patients undergoing cardiac surgery with median sternal incision admitted to Zhoukou Central Hospital from September to December 2023 were selected and randomly divided into BH group and LB group,53 cases in each group.The BH group injected locally BH with postoperative self-controlled intravenous analgesia(PCIA),LB group injected locally LB with PCIA.The visual analogue pain score(VAS),ramsay sedation score,serum pain mediators[5-hydroxytryptamine,Substance P,prostaglandin E2(PGE2),β-endorphin(β-EP)],stress hormone levels[cortisol,norepinephrine(NE)]after 6 h,12 h,24 h,48 h and 72 h of operation,postoperative analgesic drug,length of hospital stay and adverse reactions were compared between BH group and LB group.Results After 24 h,48 h and 72 h of operation,the postoperative VAS scores at resting and active state in LB group were lower than those in the BH group(P＜0.05).After 6 h,12 h,24 h,48 h and 72 h of operation,the levels of 5-hydroxytryptamine,substance P,PGE2,cortisol,NE in LB group were lower than those in the BH group,the level of β-EP was higher than that in BH group(P＜0.05).The first use of analgesic drugs in the LB group was longer than that in BH group,the cumulative use of opioids within 72 h after surgery was lower than that in BH group(P＜0.05).The hospital stay had no difference between LB group and BH group(P＞0.05).The incidence of adverse reactions had no difference between LB group and BH group(P＞0.05).Conclusion LB combined with PCIA has significant effect on elderly patients undergoing cardiac surgery with median sternal incision,which can reduce the stress response and the level of pain mediators in patients,and has no influence on the degree of sedation,with good safety.
undergoing cardiac surgery with median sternal incisionliposomes bupivacainebupivacaine hydrochloride
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