关键词: 盐酸度洛西汀； 腰椎融合术； 疼痛控制； 生活质量； 心理情绪

Abstract: Objective To discuss the optimized pain control with standard analgesia plus duloxetine hydrochloride for patients undergoing lumbar fusion surgery,and to analyze its effect on prognostic quality of life.Methods A prospective study was conducted on 106 patients who underwent lumbar fusion surgery in our hospital from May 2019 to December 2020.Patients were randomly assigned into two groups according to analgesic methods.Control group (n=52) was given standard analgesia,while observation group (n=54) received standard analgesia plus duloxetine hydrochloride.Then the degree of postoperative pain,the use of analgesics (the time of the first additional analgesic drugs,effective pressing times within 48 hours after operation),the improvement of psychological emotions,quality of life,and the occurrence of adverse reactions were compared between two groups.Results Observation group scored (4.19±0.78),(2.84±0.61) and (1.73±0.42) on visual analogue scale (VAS) at postoperative 1 d,3 d and 7 d,which were lower than (5.24±0.80),(3.51±0.57) and (2.49±0.56) in control group (P<0.05).Compared with control group,observation group had delayed time of the first additional analgesic drugs [(12.33±2.34)h vs (7.61±0.85)h] and less effective pressing times within 48 hours after operation [(3.78±0.92) vs (10.44±3.27)] than those of control group (P<0.05).Observation group scored lower on Self-rating Anxiety Scale (SAS) at postoperative 7 d [(52.44±6.71) vs (57.39±6.43)] and 14 d [(37.85±6.49) vs (42.66±5.25)],lower on Self-rating Depression Scale (SDS) at postoperative 7 d [(51.16±5.43) vs (55.37±5.25)] and 14 d [(35.64±5.36) vs (40.18±5.22)],and higher on 36-item Short-Form Health Survey (SF-36) at postoperative 4w [(83.44±6.72) vs (78.63±5.11)] than those of control group,with statistical difference (all P<0.05).The adverse reaction rate was 7.41% in observation group,which was lower than 21.15% in control group (P<0.05).Conclusion The optimized pain control with standard analgesia plus duloxetine hydrochloride for patients undergoing lumbar fusion surgery can effectively can effectively improve the analgesic effect,reduce the use of opioids,alleviate negative emotions and improve quality of life with less adverse reactions,which is worth promoting.

Key words: duloxetine hydrochloride; lumbar fusion surgery; pain control; quality of life; psychological emotions