氢吗啡酮在全子宫切除术后静脉自控镇痛中的应用效果

Efficacy of hydromorphone in postoperative patient-controlled intravenous analgesia in patients with panhysterectomy

目的探讨氢吗啡酮在全子宫切除术后静脉自控镇痛中的应用效果。方法选择行全子宫切除术患者60例,按术后静脉镇痛氢吗啡酮的不同剂量随机分为3组。A、B、C组PCIA依次采用氢吗啡酮1、2、3μg/(kg·h)。观察PCIA开始后4、8、12、24、48 h各时点视觉模拟评分(VAS)、Ramsay镇静评分、血流动力学变化、血氧饱和度,不良反应发生率以及PCIA需求按压次数。结果 PCIA开始后4、8、12、24和48 h,B组和C组VAS评分均低于A组(P<0.05),Ramsay镇静评分A组和B组均低于C组(P<0.05)。A组和B组嗜睡发生率低于C组(P<0.05),B组与C组按压次数均少于A组(P<0.05)。结论氢吗啡酮2μg/(kg·h)用于妇科子宫切除术后静脉自控镇痛安全可行,镇痛效果满意,不良反应少。

Objective To explore the efficacy of hydromorphone in postoperative patientcontrolled intravenous analgesia in patients with panhysterectomy. Methods A total of 60 patients with panhysterectomy were selected and randomly divided into three groups according to dosage of hydromorphone. Group A,group B and group C were given hydromorphone 1,2 and 3 μg /（ kg·h）respectively. VAS score,Ramsay sedation score,hemodynamics,oxygen saturation,the incidence rate of adverse reactions and PCIA pressing times were observed at the time points of 4,8,12,24,48 hours after start of PCIA. Results At the time points of 4,8,12,24,48 hours after start of PCIA,the VAS score in the group B and group C was significantly lower than that in the group A（ P〈0. 05）,and the Ramsay sedation score in the group A and the group B was significantly lower than that in the group C（ P〈0. 05）. The incidence rate of somnolence in the group A and the group B was significantly lower than that in the group C（ P〈0. 05）,and PCIA pressing times in the group B and the group C were significantly less than the group A（ P〈0. 05）. Conclusion Hydromorphone2 μg /（ kg·h） for patient-controlled intravenous analgesia after hysterectomy is feasible and safe,the analgesia efficacy is good and adverse reactions are less.