硬膜外腔注射氢吗啡酮与吗啡对吻合器环形痔切除术后镇痛效果的影响比较  

Comparison of the Effect of Epidural Injection of Hydromorphone and Morphine on Postoperative Analgesia After Circular Hemorrhoidectomy with Stapler

作　　者：曹香华 李雪萍[1] 颜浩然 李彭飞 周丽丽 周国龙 CAO Xianghua;LI Xueping;YAN Haoran;LI Pengfei;ZHOU Lili;ZHOU Guolong(Department of Anesthesiology,Dongguan Tungwah Hospital,Dongguan,Guangdong,523000)

机构地区：[1]东莞东华医院麻醉科,广东东莞523000

出　　处：《智慧健康》2023年第8期84-87,共4页Smart Healthcare

摘　　要：目的 比较分析硬膜外腔注射盐酸氢吗啡酮与盐酸吗啡对吻合器环形痔切除术后镇痛效果及安全性。方法 选择2022年3~6月在本院行吻合器环形痔切除术(PPH)60例混合痔患者为研究对象,采用随机数字表法将其随机分为氢吗啡酮组(n=30)和吗啡组(n=30),两组行腰硬联合麻醉,其中吗啡组经硬膜外导管注入利多卡因2mL+吗啡1mg+生理盐水至8mL,氢吗啡酮组经硬膜外导管注入利多卡因2mL+氢吗啡酮0.3mg+生理盐水至8mL,比较两组患者术后不同时间疼痛评分、补救镇痛百分比以及相关不良反应发生情况。结果 氢吗啡酮组术后2h、4h、6h疼痛VAS评分显著少于吗啡组(P<0.05),两组术后12h、24h的VAS分值对比无明显的差异性(P>0.05)。两组术后补救镇痛率差异无统计学意义(P>0.05)。两组术后恶心、呕吐、皮肤瘙痒、尿潴留发生概率对比无明显的差异性(P>0.05)。结论 与吗啡相比,吻合器环形痔切除术中经硬膜外腔注射氢吗啡酮能够显著减轻术后早期疼痛感,且安全性良好,更值得推广应用。Objective To compare and analyze the analgesic effect and safety of epidural injection of hydromorphone hydrochloride and morphine hydrochloride after circular hemorrhoidectomy with stapler.Methods From March 2022 to June 2022,60 patients with mixed hemorrhoids underwent circular hemorrhoidectomy(PPH)with stapler in our hospital.They were randomly divided into hydromorphone group(n=30)and morphine group(n=30).The two groups underwent combined spinal epidural anesthesia,in which morphine group was injected with morphine through epidural catheter,and hydromorphone group was injected with 0.3mg hydromorphone through epidural catheter.The pain scores,the percentage of rescue analgesia and the incidence of related adverse reactions were compared between the two groups.Results The VAS scores of pain at 2h,4h and 6h after hydromorphone operation group were significantly lower than morphine group(P<0.05),and there was no significant difference between the VAS scores at 12h and 24h after operation between the two groups(P>0.05).There was no significant difference between the two groups(P>0.05).There were no significant difference in the incidence of postoperative nausea,vomiting,skin itching and urinary retention between the two groups(P>0.05).Conclusion Compared with morphine,epidural injection of hydromorphone for the early postoperative analgesia of stapler circular hemorrhoidectomy has better effect and good safety,which is more worthy of promotion and application.

关 键 词：吻合器环形痔切除术 盐酸氢吗啡酮 盐酸吗啡 硬膜外注射 

分 类 号：R614[医药卫生—麻醉学]