术后硬膜外镇痛采取小剂量纳洛酮联合氢吗啡酮的应用效果探讨

Effect of low dose naloxone combined with hydromorphine in postoperative epidural analgesia

目的探讨对妇科手术患者行小剂量纳洛酮联合氢吗啡酮进行术后硬膜外镇痛的临床效果。方法抽取我院2016年7月~2017年6月收治的106例妇科手术患者随机分为两组进行对比研究,按照使用剂量的不同分为研究组和对照组,每组妇科手术患者均为53例。研究组行2mg氢吗啡酮+40μg纳洛酮进行联合镇痛,对照组则行2mg的氢吗啡酮+60μg纳洛酮进行联合镇痛,观察并比较两组各个时点的视觉模拟评分(VAS)、不良反应发生几率以及镇痛药物、和止吐药物的追加情况。结果两组各个时点VAS评分均<5分,差异无统计学意义(P>0.05),研究组镇痛药物追加几率7例(13.21%)与对照组8例(15.09%)比较差异无统计学意义(P>0.05),研究组的不良反应发生几率5例(9.43%)显著低于对照组13例(24.53%),研究组止吐药物追加几率2例(3.77%)显著低于对照组9例(16.98%),差异有统计学意义(P<0.05)。结论对妇科手术患者行2mg氢吗啡酮+40μg纳洛酮联合进行术后硬膜外镇痛,不仅能降低不良反应的发生几率,同时,还能够减少镇痛和止吐药物的追加情况。

Objective To investigate the clinical effect of low dose naloxone and hydromorphone postoperative epidural analgesia for gynecological patients.Methods From July 2016 to June 2017,106 patients undergoing gynecological surgery in our hospital were randomly divided into two groups according to the dosage used:study group and control group.There were 53 cases in each group.The study group were received 2mg hydromorphone+40μg naloxone for combined analgesia,while the control group were received 2mg hydromorphone+60μg naloxone for combined analgesia.The visual analogue scale(VAS)at each time point,the incidence of adverse reactions and the addition of analgesics and antiemetic drugs in the two groups were observed and compared.Results The VAS scores of the two groups were less than 5 scores,and the difference was not statistically significant(P>0.05).There were 7 cases in the study group who were given additional analgesic drug(13.21%)and 8 cases in the control group(15.09%).There was no significant difference between the two groups(P>0.05).In the study group,5 cases(9.43%)were significantly lower than the control group(13cases,24.53%),and 2 cases in the study group(3.77%)were significantly lower than the control group(9 cases,16.98%),the difference was significant(P<0.05).Conclusion Postoperative epidural analgesia combined with 2mg hydromorphone and 40μg naloxone in patients with gynecologic surgery can not only reduce the incidence of adverse reactions,but also reduce the additional analgesic and antiemetic drugs.