盐酸氢吗啡酮静脉自控镇痛用于儿童术后镇痛效果的回顾性分析  

Patient-controlled intravenous analgesia with hydromorphone for postoperative pain in children:a retrospective analysis

作　　者：王聪 朱昌茂 王茂[1] 钱巍 张咸伟[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉科,武汉430030

出　　处：《临床外科杂志》2017年第11期867-870,共4页Journal of Clinical Surgery

摘　　要：目的探讨盐酸氢吗啡酮用于儿童术后静脉自控镇痛(PCA)的临床应用效果。方法全麻术后接受48小时氢吗啡酮静脉自控镇痛的病人280例,年龄1~14岁,收集急性疼痛服务小组(acute pain service,APS)术后随访数据,包括术后4~8小时(T_1)、10~14小时(T_2)、22~26小时(T_3)、46~50小时(T_4)四次随访时病人的疼痛评分、用药剂量、PCA按压次数、镇静评分、不良反应、处理措施,以及T4时刻病人和家属满意度。结果 1~7岁儿童术后4次随访的FLACC(The Faces,Legs,Activity,Cry and Consolability Scale,0~100)疼痛评分为(7.89±11.01)、(8.58±9.83)、(6.27±6.54)、(2.58±5.14);8~14岁儿童4次随访静止VAS评分为(6.99±6.58)、(3.74±7.17)、(3.86±6.71)、(1.89±4.17),活动VAS评分为(14.40±9.24)、(9.46±10.39)、(7.73±9.66)、(8.27±7.94);各随访时刻Ramsay镇静评分为2,48小时内恶心呕吐率为8.22%,无呼吸抑制、过度镇静、皮肤瘙痒等不良反应,术后镇痛满意度为5。结论盐酸氢吗啡酮PCA用于儿童术后镇痛效果良好,不良反应发生率低。Objective To explore the clinical efficacy of intravenous patient-controlled analgesia（PCA） with hydromorphone for postoperative pain in children.Methods The clinical data,280 children receiving surgery under general anesthesia with postoperative intravenous PCA with hydromorphone for 48 hours from January to December 2016,were collected by acute pain service（APS） at 4 - 8 hour（T1）,10 -14 hour（T2）,22 - 26 hour（T3）,46 - 50 hour（T4） after surgery.Pain scores,opioid consumption,sedation score,adverse reactions,intervening measures and patient or parent satisfaction were recorded during the intravenous PCA follow-up course.Results At T1,T2,T3 and T4 after surgery,patients of 1 to 7 years old FLACC cores（The faces,legs,activity,cry and consolability scale,0 - 100） were（7.89 ± 11.01）,（8.58± 9.83）,（6.27 ± 6.54）,（2.58 ± 5.14）,respectively; patients of 8 to 14 years old VAS scores at rest were（6.99 ± 6.58）,（3.74 ± 7.17）,（3.86 ± 6.71）,（1.89 ± 4.17）,and were（14.40 ± 9.24）,（9.46± 10.39）,（7.73 ± 9.66）,（8.27 ± 7.94） during movement; Ramsay sedation score was 2,the incidence of nausea and vomiting was 8.22%,there were no respiratory depression,excessive sedation and pruritus,and the patient or parent satisfaction with postoperative analgesia was 5.Conclusion PCA with hydromorphone is safe and effective in postoperative pain therapy with moderate side effects in children.

关 键 词：氢吗啡酮 儿童 术后镇痛 病人自控镇痛 

分 类 号：R726.1[医药卫生—儿科]