Background: There are few literatures analyze the effects of traumatic thoracolumbar vertebral fractures on prognosis pain and functional recovery from the perspective of analgesics used in the perioperative period, and lack of clinical guidance on the application of analgesics for its surgery.
Objective: To analyze the effects of peri-treatment analgesics on pain and recovery status of patients with thoracolumbar fractures combined with network pharmacology.
Methods: 719 patients with thoracolumar fractures were collected and divided into acetaminophen dihydrocodeine group (n=476), celecoxib group (n=130) and etoricoxib group (n=113) according to the use of analgesics. The visual analogue scale (VAS) was used to measure the degree of pain the number of days of the use of three analgesics, the postoperative Oswestry dysfunction index (ODI) scores and some Japanese orthopedics Association score (JOA) were recorded. The targets of three analgesics were obtained by Drugbank, and the target of acute pain caused by fracture is obtained by Genecards, then Venn diagram of the intersection genes was drawn through Venn. Protein interaction mapping (PPI) was obtained by using STRING database, the functional enrichment analysis of Gene Ontology (GO) and the enrichment analysis of Kyoto Encyclopedia of Genes and Genomics (KEGG) pathway were carried out based on Metascape database.
Results: The codeine group was higher than celecoxib and etoricoxib groups in the number of days of preoperative and postoperative analgesic use, VAS score difference on the preoperative and postoperative, and postoperative ODI index (all P<0.01). There exist no statistically conspicuous differences among the three groups in basic characteristics, injury and intraoperative conditions, ODI score except ODI index, three JOA marks, and postoperative walking ability (P>0.05). Identify 3332 disease targets. PPI network analysis identified OPRM1, OPRK1, TRPV1, PTGS1 and PTGS2 as the core targets for acetaminophen dihydrocodeine in the treatment.
Conclusion: If multiple analgesic modes are adopted in the perioperative analgesic use, and the use of acetaminophen dihydrocodeine in combination with anti-inflammatory analgesics, the duration of analgesic use is expected to be shortened as far as possible to reduce the pain degree in postoperative recovery, providing a reference for the optimal use of anesthetics for clinical traumatic thoracolumbar fractures.