氢吗啡酮预防瑞芬太尼复合麻醉患者术后痛觉过敏的临床效果  

Clinical Effect of Hydromorphone in Preventing Postoperative Hyperalgesia in Patients Undergoing Remifentanil Combined Anesthesia

作　　者：王燕丽 WANG Yanli(Department of Anesthesiology,Wuxi Kaiyi Hospital,Wuxi,Jiangsu 214142,China)

机构地区：[1]无锡凯宜医院麻醉科,江苏无锡214142

出　　处：《中国医药指南》2025年第2期101-104,共4页Guide of China Medicine

摘　　要：目的研究氢吗啡酮在预防瑞芬太尼复合麻醉患者术后痛觉过敏方面的效果。方法采用随机数法将2022年12月至2024年3月到凯宜医院治疗的80例瑞芬太尼复合麻醉患者分为观察组和对照组,每组40例。对照组采用地佐辛进行术后痛觉过敏的干预,观察组则采用氢吗啡酮进行术后痛觉过敏干预,比较两组患者的手术切口周围痛阈、患者的苏醒、拔管时间、镇痛药物用量和镇痛泵按压次数、痛觉过敏程度、不良反应发生率等。结果术前两组患者的切口周围痛阈差异无统计学意义(P>0.05),术后6 h、术后12 h、术后24 h、术后48 h患者的切口周围痛阈比对照组更低(P<0.05)。观察组的苏醒时间和拔管时间和对照组相比差异无统计学意义(P>0.05)。镇痛药用量、镇痛泵按压次数少于对照组(P<0.05)。观察组的痛觉过敏程度明显比对照组更轻(P<0.05)。观察组的不良反应发生率低于对照组(P<0.05)。结论将氢吗啡酮应用在瑞芬太尼复合麻醉的患者中能有效地减轻患者切口周围的痛阈,可以减少镇痛药物用量和镇痛泵按压次数,减轻其痛觉过敏程度和出现不良反应的概率。Objective To study the effect of hydromorphone in preventing postoperative hyperalgesia in patients undergoing remifentanil combined anesthesia.Methods 80 patients undergoing remifentanil combined anesthesia who were treated in our hospital from December 2022 to March 2024 were divided into observation group and control group using a random number method,40 patients in each group.The control group received dezocine for postoperative hyperalgesia intervention,while the observation group received hydromorphone for postoperative hyperalgesia intervention.The perioperative pain threshold around the surgical incision,time to awakening and extubation,analgesic drug dosage,number of analgesic pump presses,degree of hyperalgesia,and incidence of adverse reactions were compared between the two groups.Results There was no statistically significant difference in the incision perimeter pain threshold between the two groups before surgery(P>0.05).At 6 hours,12 hours,24 hours,and 48 hours postoperatively,the incision perimeter pain threshold in the observation group was significantly improved compared to the control group(P<0.05).There was no statistically significant difference in awakening time and extubation time between the observation group and the control group(P>0.05).However,the amount of analgesic medication administered and the frequency of analgesic pump activations were notably lower in the observation group compared to the control group(P<0.05).The level of hyperalgesia experienced by patients in the observation group lower than that in the control group(P<0.05).The occurrence of adverse reactions was less frequent in the observation group when compared to the control group(P<0.05).Conclusions The application of hydromorphone in patients undergoing remifentanil combined anesthesia can effectively reduce the pain threshold around the incision,decrease the dosage of analgesic drugs and the number of analgesic pump presses,reduce the degree of hyperalgesia and the probability of adverse reactions.It is worthy of reco

关 键 词：痛觉过敏 氢吗啡酮 瑞芬太尼 麻醉 痛阈 不良反应 

分 类 号：R614[医药卫生—麻醉学]