氢吗啡酮在开腹患者术后镇痛中的应用  

Application of Hydromorphinone in Postoperative Analgesia of Patients Undergoing Laparotomy

作　　者：魏本忠 高华林 杨柳青[2] Wei Benzhong;Gao Hualin;Yang Liuqing(Department of Anesthesiology,Yizheng Hospital of Nanjing Gulou Hospital Group,Yizheng 211400,China;North Jiangsu People’s Hospital,Yangzhou 225001,China)

机构地区：[1]南京鼓楼医院集团仪征医院麻醉科,江苏仪征211400 [2]苏北人民医院麻醉科,江苏扬州225001

出　　处：《湖北民族大学学报（医学版）》2020年第2期43-45,48,共4页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的观察氢吗啡酮在开腹患者术后镇痛中的应用。方法择期胃癌根治术患者40例,随机双盲分为氢吗啡酮联合舒芬太尼(HS)组和单纯舒芬太尼(S)组,每组20例。术后所有患者行PCIA,HS组静脉镇痛泵配方为氢吗啡酮0.3 mg/kg、舒芬太尼2μg/kg、托烷司琼10 mg加生理盐水稀释至100 mL,而S组配方为舒芬太尼3μg/kg、托烷司琼10 mg加生理盐水稀释至100 mL。记录两组患者术后6 h、12 h和24 h的疼痛视觉模拟评分(VAS)、Ramsay镇静评分(RSS)、PCIA有效按压次数、肛门排气时间及各种不良反应发生率。结果两组患者术后各时点VAS评分和RSS评分差异无统计学意义(P>0.05);HS组有效按压次数明显低于S组(P<0.05);HS组头晕、嗜睡和呼吸抑制发生率明显低于S组(P<0.05);HS组术后肛门排气时间明显短于S组(P<0.05)。结论与单用舒芬太尼相比,氢吗啡酮联合舒芬太尼行PCIA镇痛效果相当,但不良反应发生率相对较低,肛门排气时间更短。Objective To observe the effect of hydromorphine ketone in postoperative analgesia of patients undergoing laparotomy.Methods 40 patients with elective radical gastrectomy were randomly divided into HS group and S group,20 patients in each group.All the patients underwent postoperative PCIA.The intravenous analgesic pump in the HS group was formulated with hydromorphine 0.3 mg/kg,sufentanil 2μg/kg,tropisetron 10 mg and normal saline diluted to 100 mL,while the formula in the S group was formulated with sufentanil 3μg/kg and tropisetron 10 mg and normal saline diluted to 100 mL.Visual analogue pain score(VAS),Ramsay sedation score(RSS),PCIA effective compression times,anal exhaust time and the incidence of various adverse reactions were recorded at 6 h,12 h and 24 h after surgery.Results There was no significant difference between the two groups in VAS score and RSS score at each postoperative time point(P>0.05).The effective compression times in HS group were significantly lower than those in S group(P<0.05).The incidence of dizziness,drowsiness and respiratory depression in HS group was significantly lower than that in S group(P<0.05).Postoperative anal exhaust time in HS group was significantly shorter than that in S group(P<0.05).Conclusion Compared with sufentanil alone,hydromorphinone combined with sufentanil has the same analgesic effect as that of PCIA,but the incidence of adverse reactions is relatively low and the time of anal exhaust is shorter.

关 键 词：氢吗啡酮 舒芬太尼 胃癌 患者自控静脉镇痛 

分 类 号：R614[医药卫生—麻醉学]