硬膜外腔注射不同剂量盐酸氢吗啡酮对子宫切除术后疼痛及应激反应的影响  

Effects of Epidural Injection of Different Doses of Hydromorphone Hydrochloride on Pain and Stress Response After Hysterectomy

作　　者：钟伟博 杨桥 ZHONG Wei-bo;YANG Qiao(Gannan Medical University,Ganzhou 341000,Jiangxi,China;Department of Anesthesiology,Ganzhou People's Hospital,Ganzhou 341000,Jiangxi,China)

机构地区：[1]赣南医学院,江西赣州341000 [2]赣州市人民医院麻醉科,江西赣州341000

出　　处：《医学信息》2021年第24期135-137,共3页Journal of Medical Information

摘　　要：目的观察硬膜外腔注射不同剂量盐酸氢吗啡酮对子宫切除术后疼痛及应激反应的影响。方法选取2020年1月-2021年8月我院收治的子宫切除术患者92例,均应用腰-硬联合麻醉下,随机分为对照组和观察组,每组46例。对照组硬膜外腔注射盐酸氢吗啡酮0.6 mg与7.5 mg罗哌卡因混合液,观察组硬膜外腔注射盐酸氢吗啡酮0.4 mg与7.5 mg罗哌卡因混合液。比较两组患者不同时间点疼痛(VAS)评分、镇静评分、心率(HR)、有创平均动脉压(MAP)、血氧饱和度(SpO_(2))变化情况以及不良反应情况。结果术后6 h观察组VAS评分大于对照组,差异有统计学意义(P<0.05),术后12 h两组VAS评分均大于术后6 h(P<0.05),但差异无统计学意义(P>0.05);术后6、12 h两组镇静评分比较,差异无统计学意义(P>0.05);术后6、12 h两组HR、MAP均大于麻醉前,但观察组小于对照组(P<0.05),两组不同时间点SpO_(2)比较,差异无统计学意义(P>0.05);观察组不良反应发生率为4.35%,低于对照组的13.04%(P<0.05)。结论硬膜外腔注射不同剂量盐酸氢吗啡酮对子宫切除术后疼痛均有一定的影响,但是0.4 mg基本可实现与0.6 mg相同的镇痛和镇静效果,且对HR、MAP、SpO_(2)影响较小,可一定程度减轻应激反应,同时临床不良反应小,具有相对更优的安全性。Objective To observe the effect of epidural injection of different doses of hydromorphone hydrochloride on pain and stress response after hysterectomy.Methods A total of 92 patients with hysterectomy admitted to our hospital from January 2020 to August 2021 were selected and randomly divided into control group and observation group under combined spinal-epidural anesthesia,with 46 cases in each group.The control group received epidural injection of hydromorphone hydrochloride 0.6 mg and 7.5 mg ropivacaine mixture,and the observation group received epidural injection of hydromorphone hydrochloride 0.4 mg and 7.5 mg ropivacaine mixture.The pain(VAS)score,sedation score,heart rate(HR),mean arterial pressure(MAP),oxygen saturation(SpO_(2))and adverse reactions were compared between the two groups.Results The VAS score at 6 h after operation in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05);the VAS scores at 12 h after operation in both groups were higher than those at 6 h after operation,but the difference was not statistically significant(P>0.05).There was no significant difference in sedation score at 6 and 12 h after operation between the two groups(P>0.05).At 6 and 12 h after operation,HR and MAP in the two groups were higher than those before anesthesia,but those in the observation group were lower than the control group(P<0.05).There was no significant difference in SpO_(2) at different time points between the two groups(P>0.05).The incidence of adverse reactions in the observation group was 4.35%,which was lower than 13.04%in the control group(P<0.05).Conclusion Epidural injection of different doses of hydromorphone hydrochloride has a certain effect on postoperative pain after hysterectomy,but 0.4 mg can basically achieve the same analgesic and sedative effects as 0.6 mg,and has little effect on HR,MAP and SpO_(2),which can reduce the stress response to a certain extent.At the same time,the clinical adverse reactions are small,and it ha

关 键 词：硬膜外腔注射 盐酸氢吗啡酮 子宫切除术 应激反应 

分 类 号：R971.2[医药卫生—药品]