氢吗啡酮在妇科腔镜手术中的镇痛作用研究

Study on Analgesic Effect of Hydromorphone in Gynecological Laparoscopic Surgery

目的:观察静脉注射氢吗啡酮在妇科腔镜手术中的镇痛作用。方法:选取择期行妇科腔镜手术的患者46例,随机分为氢吗啡酮组(H组)和对照组(C组),每组23例。在七氟烷吸入麻醉的基础上,H组手术开始前15 min静脉推注盐酸氢吗啡酮10μg/kg,C组手术开始前静脉推注芬太尼1μg/kg。观察两组围术期芬太尼使用的总量,苏醒时间、拔管时间,记录两组拔管后1 h Ramsay镇静评分以及Price-henry镇痛评分。结果:与C组相比,H组术中芬太尼使用剂量明显减少,苏醒时间、拔管时间缩短,术后镇静程度适中,镇痛更为完善,差异均有统计学意义(P<0.05)。结论:盐酸氢吗啡酮静脉推注用于妇科腔镜手术,可以减少术中芬太尼的用量,有助于平稳渡过苏醒期,具有良好的应用价值。

Objective：To observe the analgesic effect of intravenous injection of Hydromorphone in gynecological laparoscopic surgery.Method：46 patients undergoing elective gynecologic laparoscopic surgery,they were randomly divided into hydromorphone group（H group） and control group（C group）,23 cases in each group.On the basis of seven sevoflurane inhalation anesthesia,H group of 15 min intravenous injection of morphine hydrochloride before the start of the 10 μg/kg intravenous injection of morphine hydrochloride, C group received intravenous injection of fentanyl 1 μg/kg.Observed the two groups of perioperative use of fentanyl,recovery time,extubation time,recorded two groups after extubation 1 h Ramsay sedation score and Price-henry analgesia score. Result：Compared with C group,in H group,the dosage of fentanyl was significantly reduced,the recovery time,extubation time was shortened, the degree of sedation was moderate, the analgesia was improved,and the differences were statistically significant（P〈0.05）.Conclusion： Hydromorphone hydrochloride intravenous bolus for gynecological laparoscopic surgery,can reduce the amount of intraoperative fentanyl,contribute to smoothly through the recovery period,has good application value.