盐酸氢吗啡酮用于重症监护室神经外科术后镇痛的临床研究

Clinical study of hydromorphone hydrochloride for postoperative analgesia in intensive care unit neurosurgery

目的:探究盐酸氢吗啡酮在重症监护室神经外科术后镇痛中的临床应用效果。方法:选取2020年6月—2023年6月在溧阳市人民医院ICU住院治疗的106例神经外科术后患者,采用随机数表方法分为对照组与试验组,每组53例。对照组术后采用瑞芬太尼进行镇痛治疗,试验组术后采用盐酸氢吗啡酮进行镇痛治疗。比较两组疼痛评分、镇静程度、炎性因子水平及不良反应发生情况。结果:试验组术后4、12 h的疼痛评分低于对照组,差异有统计学意义(P<0.05)。试验组术后4、12 h的镇静程度评分低于对照组,差异有统计学意义(P<0.05)。手术结束时,两组肿瘤坏死因子(TNF-α)、白细胞介素-8(IL-8)、C反应蛋白(CRP)、白细胞介素-6(IL-6)水平比较,差异无统计学意义(P>0.05);在术后4、12 h,两组TNF-α、IL-8、CRP、IL-6水平均低于手术结束时,且试验组低于对照组,差异有统计学意义(P<0.05)。试验组的不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论:盐酸氢吗啡酮应用于ICU神经外科术后镇痛,能明显减轻患者术后疼痛,使患者保持镇静,可降低患者的炎症反应水平,且不良反应少,可加快患者的恢复。

Objective To explore the clinical application effect of hydromorphone hydrochloride in postoperative analgesia in intensive care unit neurosurgery.Methods 106 patients undergoing neurosurgery in the ICU who were hospitalized at Liyang People's Hospital from June 2020 to June 2023 were selected and randomly divided into a control group and an experimental group using a random number table method,with 53 patients in each group.The control group received postoperative analgesic treatment with remifentanil,while the experimental group received postoperative analgesic treatment with hydromorphone hydrochloride.Compare the pain scores,sedation levels,inflammatory levels,and adverse reactions between the two groups.Results The pain scores of the experimental group at 4 and 12 hours after surgery were lower than those of the control group,with a statistically significant difference(P<0.05).The sedation score of the experimental group at 4 and 12 hours after surgery was lower than that of the control group,with a statistically significant difference(P<0.05).At the end of the surgery,two groups of tumor necrosis factor(TNF-α),There was no statistically significant difference in the levels of interleukin-8(IL-8),C-reactive protein(CRP),and interleukin-6(IL-6)(P>0.05);At 4 and 12 hours after surgery,both groups of TNF-α,The average levels of IL-8,CRP,and IL-6 were lower than those at the end of surgery,and the experimental group was lower than the control group,with statistically significant differences(P<0.05).The incidence of adverse reactions in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusions The application of hydromorphone hydrochloride in the ICU for postoperative analgesia in neurosurgery can significantly reduce postoperative pain,maintain sedation,reduce inflammatory levels,and have fewer adverse reactions,accelerating patient recovery.