盐酸氢吗啡酮用于ICU全身麻醉心瓣膜术后机械通气患者镇痛的有效性及安全性分析  

Efficacy and Safety Analysis of Hydromorphone Hydrochloride for Analgesia in Patients with Mechanical Ventilation after Cardiac Valve Surgery under General Anesthesia in ICU

作　　者：周智慧[1] Zhou Zhihui(Department of Critical Care Medicine,Chongqing People's Hospital(the Affiliated People's Hospital of Chongqing University),Chongqing 401147,China)

机构地区：[1]重庆市人民医院(重庆大学附属人民医院)重症医学科,重庆401147

出　　处：《中外医药研究》2024年第17期75-77,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

基　　金：中关村精准医学基金会赞助科研项目(编号:Qmft2021)。

摘　　要：目的:分析盐酸氢吗啡酮用于ICU全身麻醉心瓣膜术后机械通气患者镇痛的有效性及安全性。方法:选取2022年4月—2023年5月重庆市人民医院(重庆大学附属人民医院)重症医学科收治的全身麻醉心瓣膜术后行机械通气的患者60例作为研究对象,随机分为观察组和对照组,各30例。观察组给予盐酸氢吗啡酮镇痛,对照组给予芬太尼镇痛。比较两组患者各时间点重症监护疼痛观察工具评分(CPOT)、呼吸频率(RR)、心率(HR)、平均动脉压、试验用药时间、有创机械通气时间、入住ICU时间、不良反应发生情况。结果:两组患者用药后6 h、12 h、24 h各时间点的CPOT评分比较,差异无统计学意义(P>0.05),但CPOT评分均低于用药前,差异有统计学意义(P<0.05)。用药后,随着时间的延长,RR和HR逐渐增加,且观察组HR随时间增加的速度快于对照组,差异有统计学意义(P<0.05)。观察组试验用药时间、有创机械通气时间及入住ICU时间短于对照组,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(χ^(2)=0.647,P=0.421)。结论:对于全身麻醉心瓣膜术后机械通气的患者,氢吗啡酮与芬太尼镇痛效果相当,导致谵妄的可能性更小,对呼吸的抑制更小,能缩短该类患者机械通气及ICU的住院时间。Objective:To analyze the efficacy and safety of hydromorphone hydrochloride for analgesia in mechanical ventilation patients after cardiac valve surgery under general anesthesia in ICU.Methods:A total of sixty patients undergoing mechanical ven⁃tilation after cardiac valve surgery under general anesthesia admitted to the Department of Critical Care Medicine of Chongqing People's Hospital(the Affiliated People's Hospital of Chongqing University)from April 2022 to May 2023 were selected as the study objects,and were randomly divided into observation group and control group,with thirty patients in each group.The obser⁃vation group was given hydromorphone hydrochloride analgesia,and the control group was given fentanyl analgesia.The critical care pain observation tool score(CPOT),respiratory rate(RR),heart rate(HR),mean arterial pressure,experimental medication time,invasive mechanical ventilation time,ICU stay time,and adverse reactions were compared between the two groups at each time point.Results:There was no significant difference in CPOT score between 2 groups at 6 h,12 h and 24 h after medication(P>0.05);however,CPOT scores were all lower than before medication,and the difference was statistically significant(P<0.05);af⁃ter treatment,RR and HR increased gradually with the extension of time,and the HR in observation group increased faster than that in control group with time,the difference was statistically significant(P<0.05);the experimental medication time,invasive mechanical ventilation time and ICU stay time in observation group were shorter than those in control group,and the differences were statistically significant(P<0.05);there was no significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.647,P=0.421).Conclusion:For patients undergoing mechanical ventilation after cardiac valve surgery under general anesthesia,hydromorphone has the same analgesic effect as fentanyl,which is less likely to cause delirium,less respiratory inhibi⁃tion,and can shorten the leng

关 键 词：全身麻醉心瓣膜术后 机械通气 氢吗啡酮 芬太尼 镇痛效果 不良反应 

分 类 号：R654.2[医药卫生—外科学]