Effects of Esketamine Combined with Sufentanil for Postoperative Patient-Controlled Analgesia on Pain,Stress Hormones and Immune Function in Patients Undergoing Spinal Surgery
Objective:To investigate the effects of esketamine combined with sufentanil used for postoperative patient-controlled analgesia on immune function,inflammatory factors,pain substances and stress hormone in patients undergoing spinal surgery.Methods:A total of 100 patients with internal fixation of thoracic and lumbar fractures admitted to a hospital from June 2021 to June 2023 were selected as the study objects,and were divided into control group and observation group by random number table method,with 50 cases in each group.Postoperatively,patients in both groups were given tropisetron hydrochloride for injection to prevent nausea and vomiting.The control group was given sufentanil citrate injection after surgery,while the observation group was given esketamine hydrochloride injection in addition to the control group.Compare the postoperative analgesic effects[visual analog scale(VAS)],blood pressure and heart rate,pain substances[substance P(SP),5-hydroxytryptamine(5-HT),β-endorphin(β-EP)],stress hormones[cortisol(Cor),norepinephrine(NE)],immune function[CD3+,CD4+,CD8+,CD4+/CD8+,natural killer cell(NK cell)],inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],and incidence of adverse reactions between the two groups.Results:The VAS scores at 4h,8h,16h and 24h after operation were lower in the observation group than those in the control group(P<0.05).There was no statistically significant difference in systolic blood pressure,diastolic blood pressure and heart rate at 30min,2h and 4h after operation between the two groups(P>0.05).The levels of SP,NE,5-HT and Cor in observation group were lower than those in control group at 24h and 48h after operation(P<0.05),and the levels of β-EP were higher than those in control group(P<0.05).The CD3+,CD4+,NK cell and CD4+/CD8+in observation group were higher than those in control group at 24h and 48h after operation(P<0.05),and CD8+were lower than those in control group(P<0.05).The levels of IL-6 and TNF-α at 24h and 48h after operation were lower in the observation group than those in the control group(P<0.05).No statistically significant difference in the incidence of adverse reactions was observed between the two groups(P>0.05).Conclusion:The analgesic effect of esketamine combined with sufentanil in patients undergoing spinal surgery is favorable as it can effectively relieve pain,reduce the body stress and inflammatory reaction,and improve immune function,without additional risks of adverse reactions.
esketaminesufentanilpatient-controlled analgesiaspinal surgeryimmune function
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