氢吗啡酮联合酮咯酸氨丁三醇在腹腔镜胆囊切除患者镇痛中的应用

Application of hydromorphone combined with ketorolac tromethamine in analgesia for patients undergoing laparoscopic cholecystectomy

目的探讨氢吗啡酮联合酮咯酸氨丁三醇用于腹腔镜胆囊切除患者镇痛中的价值。方法选取临沂市中心医院2020年7月至2022年6月收治的腹腔镜胆囊切除患者112例进行随机对照试验。采用随机数表法将其分为研究组和常规组,各56例。研究组男34例,女22例,年龄(59.36±12.36)岁。常规组男33例,女23例,年龄(59.96±13.52)岁。研究组采用氢吗啡酮与酮咯酸氨丁三醇,常规组采用酮咯酸氨丁三醇。观察两组患者住院时间、手术时间、术后疼痛程度[视觉模拟评分法(VAS)评分]及术后不良反应发生情况。采用t检验和χ^(2)检验。结果研究组住院时间短于常规组[(5.58±3.01)d比(8.52±3.14)d,t=5.058,P<0.001]。两组术后9 h VAS评分低于术后6 h;研究组术后6 h、9 h VAS评分均低于常规组(t=37.133、26.641,均P<0.001)。研究组不良反应发生率低于常规组[5.36%(3/56)比17.86%(10/56),χ^(2)=4.264,P=0.039]。结论氢吗啡酮0.04 mg/kg联合酮咯酸氨丁三醇0.5 mg/kg用于腹腔镜胆囊切除患者中,有利于促进患者苏醒,镇静效果显著,还可降低不良反应发生率,值得推广。

Objective To explore the value applying hydromorphone combined with ketorolac tromethamine in analgesia for patients undergoing laparoscopic cholecystectomy.Methods One hundred and twelve patients who took laparoscopic cholecystectomy in Linyi Central Hospital from July 2020 to June 2022 were selected for the randomized controlled trial.They were divided into a study group and a conventional group by the random number table method,with 56 cases in each group.There were 34 males and 22 females in the study group;they were(59.36±12.36)years old.There were 33 males and 23 females in the conventional group;they were(59.96±13.52)years old.The study group were anesthetized with hydromorphone and ketorolac tromethamine,and the conventional group with ketorolac tromethamine.The hospital stays,operation times,postoperative pain degrees[score of Visual Analog Scale(VAS)],and adverse reactions of the two groups were observed.t andχ^(2) tests were applied.Results The hospital stay in the study group was shorter than that in the conventional group[(5.58±3.01)d vs.(8.52±3.14)d;t=5.058,P<0.001].The VAS scores in both group were lower 9 than 6 h after the operation;the VAS scores 6 and 9 h after the operation in the study group were lower than those in the conventional group(t=37.133 and 26.641,both P<0.001).The incidence of adverse reactions in the study group was lower than that in the conventional group[5.36%(3/56)vs.17.86%(10/56);χ^(2)=4.264,P=0.039].Conclusion For patients undergoing laparoscopic cholecystectomy,0.04 mg/kg hydromorphone combined with 0.5 mg/kg ketorolac tromethamine can promote their recovery and reduce the incidence of adverse reactions,and has significant sedative effect,so it is worthy of promotion.