盐酸氢吗啡酮硬膜外腔单次注射联合PCIA在经尿道前列腺电切术后的应用  

Application of Hydromorphone Hydrochloride Epidural in A Single Injection Combined with PCIA after Transurethral Resection of Prostate

作　　者：钱珊珊 曹学照[1] QIAN Shanshan;CAO Xuezhao(The First Affiliated Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院,辽宁沈阳110001

出　　处：《中国医学创新》2020年第3期29-32,共4页Medical Innovation of China

摘　　要：目的:评价盐酸氢吗啡酮硬膜外腔单次注射联合静脉自控镇痛(PCIA)对经尿道前列腺电切术(TURP)后患者的镇痛效果及安全性。方法:选取2017年12月-2018年12月在本院拟行TURP患者60例。采用随机双盲抽签法分为A、B、C组,每组20例。TURP术后,A组给予PCIA;B组给予氢吗啡酮0.2 mg硬膜外腔单次注射联合PCIA;C组给予吗啡2 mg硬膜外腔单次注射联合PCIA。比较三组术后4 h(T1)、12 h(T2)、24 h(T3)及48 h(T4)静息状态下疼痛评分(R-VAS)、运动状态下疼痛评分(M-VAS)及镇静效果;比较三组术后48 h内不良反应、术后48 h内PCIA有效按压次数、镇痛补救情况及术后72 h镇痛满意情况。结果:A组在T1~4时R-VAS与M-VAS评分均高于B、C组(P<0.05);B组在T1时R-VAS与M-VAS均低于C组(P<0.05)。B、C组在T1~4时镇静效果均优于A组(P<0.05)。C组恶心呕吐与皮肤瘙痒发生率均明显高于A、B组(P<0.05)。A组膀胱刺激征(CRBD)发生率均明显高于B、C组(P<0.05)。A组PCIA按压次数与镇痛补救率均高于B、C组(P<0.05);B、C组镇痛总满意率均明显高于A组(P<0.05),B组镇痛总满意率高于C组(P<0.05)。结论:氢吗啡酮硬膜外单次注射联合PCIA用于TURP术后镇痛效果确切,不良反应少,安全性高。Objective:To evaluate the analgesic effect and safety of Hydromorphone Hydrochloride epidural in a single injection combined with patient-controlled intravenous analgesia(PCIA)on patients after transurethral resection of prostate(TURP).Method:A total of 60 patients with TURP in our hospital from December 2017 to December 2018 were selected.They were randomly divided into group A,B and C by double-blind lottery,20 cases in each group.After TURP,group A was given PCIA.Group B was given 0.2 mg Hydromorphone epidural in a single injection combined with PCIA.Group C was given Morphine 2 mg epidural in a single injection combined with PCIA.The pain scores in resting state(R-VSA),the pain scores in exercise state(M-VAS)and sedation effect of the three groups were compared at 4 h(T1),12 h(T2),24 h(T3)and 48 h(T4)after the operation.Adverse reactions within 48 h after operation were compared among the three groups.The number of effective PCIA presses and analgesia recovery within 48 h after the operation and satisfaction of postoperative analgesia at 72 h were compared among the three groups.Result:R-VAS and M-VAS scores in group A were higher than those in group B and C at T1-4(P<0.05).R-VAS and M-VAS scores in group B were lower than those in group C at T1(P<0.05).The sedation effect of group B and C were better than those of group A at T1-4.The incidence of nausea,vomiting and itching in group C were significantly higher than those in group A and B(P<0.05).The incidence of cathetery related bladder irritation(CRBD)in group A were significantly higher than those in group B and C(P<0.05).The number of effective PCIA presses and analgesic recovery rate in group A were higher than those in group B and C(P<0.05).The total satisfaction rate of analgesia in group B and C were significantly higher than those in group A(P<0.05),and the total analgesic satisfaction rate of group B was higher than that of group C(P<0.05).Conclusion:Hydromorphone Hydrochloride epidural in a single injection combined with PCIA for TURP postoperativ

关 键 词：盐酸氢吗啡酮 硬膜外腔单次注射 自控静脉镇痛 经尿道前列腺电切术 

分 类 号：R614[医药卫生—麻醉学]