盐酸氢吗啡酮与盐酸吗啡对前列腺电切术后硬膜外镇痛效果比较

Comparison of Epidural Analgesia Effect Between Morphine and Hydromorphone for Patients after Electrotomy of Prostate

目的对比分析盐酸氢吗啡酮与盐酸吗啡对前列腺电切术后硬膜外镇痛效果;方法选取86例良性前列腺增生采用前列腺电切术治疗患者,随机分为盐酸吗啡组和盐酸氢吗啡酮组,比较两组患者手术结束时、术后2、4、6、12、24h VAS和Ramsay评分及术后不良反应发生情况;结果两组患者手术结束时VAS、Ramsay评分差异无统计学意义(P>0.05),手术结束到术后6h时间段盐酸吗啡组患者的VAS评分高于盐酸氢吗啡酮组患者,Ramsay评分低于盐酸氢吗啡酮组患者,术后6h到术后24h时间段盐酸吗啡组患者的VAS评分低于盐酸氢吗啡酮组患者,Ramsay评分高于盐酸氢吗啡酮组患者,差异均具有统计学意义(P<0.05),术后6、24h两组患者VAS评分,术后24h两组患者Ramsay评分差异无统计学意义(P>0.05),两组患者不良反应发生率差异无统计学意义(P>0.05);结论盐酸氢吗啡酮与盐酸吗啡对前列腺电切术后硬膜外镇痛均有效果,但是术后6h内盐酸氢吗啡酮的镇痛效果更显著,且未出现不良反应,安全性较高,临床上具有广泛应用的前景。

Objective To observe analgesia effect of morphine hydrochloride and hydromorphone hydrochloride in patients after transurethral resection of prostate. Methods 86 cases of benign prostatic hyperplasia patients after transurethral resection of the pros- tate were selected and randomly divided into morphine hydrochloride group and hydromorphone hydrochloride group. The VAS and Ramsay scores at 2, 4, 6, 12, and 24 h postoperatively between the two groups at the end of operation and the incidence of adverse events were compared. Results There was no significant difference in VAS and Ramsay scores between the two groups （P 〉 0.05 ）. The VAS scores of the morphine group were higher than those of the hydromorphone group at 6 hours after operation and Ramsay score The VAS scores of the patients in the group of morphine hydrochlorlde and the group of patients in the hydromorphone group were significantly lower than those in the group of hydromorphone hydrochloride at 6 hours and 24 hours after operation, and the Ramsay score was higher than that in the group of hydromorphone hydrochloride, the differences were statistically significant （P 〈 0.05）. There was no significant difference in VAS score and Ramsay score between the two groups at 6 and 24 hours after operation （P 〉 0.05）. There was no significant difference between the two groups in the incidence of adverse reactions （P 〉 0.05） . Conclusion Hydroxymorphone hydrochloride and morphine hydrochloride have effect on epidural analgesia after transurethral resection of the prostate. However, the analgesic effect of hydromorphone hydrochloride is more remarkable in 6 hours after operation, and no adverse reaction occurs. Safety is high, clinical application has broad prospects.