不同剂量氢吗啡酮联合氟比洛芬酯用于剖宫产术后自控静脉镇痛中的效果

Effect of Different Doses of Hydromorphone Combined with Flurbiprofen Axidate on Self-controlled Intravenous Analgesia after Cesarean Section

目的探讨不同剂量氢吗啡酮联合氟比洛芬酯用于剖宫产术后自控静脉镇痛中的效果。方法选取2021年3月至2023年2月于阜新市中心医院完成剖宫产的98例产妇作为研究对象,按随机数字表法分为试验组与对照组,各49例。所有产妇剖宫产术后均行自控静脉镇痛,对照组给予常规剂量(0.10 mg/kg)氢吗啡酮联合氟比洛芬酯镇痛,试验组给予高剂量(0.30 mg/kg)氢吗啡酮联合氟比洛芬酯镇痛。记录两组产妇的镇痛效果与不良反应发生情况。结果两组术后2 h、24 h、48 h的视觉模拟评分法(VAS)评分呈降低趋势,且试验组术后各时间点VAS评分均显著低于对照组,差异有统计学意义(P<0.05);两组术后2 h、24 h、48 h的镇静Ramsay评分比较差异无统计学意义(P>0.05);试验组术后48 h的不良反应发生率与对照组比较,差异无统计学意义(P>0.05);试验组镇痛药物用量、自控静脉镇痛泵按压次数显著少于对照组(P<0.05)。结论高剂量氢吗啡酮联合氟比洛芬酯用于剖宫产术后自控静脉镇痛中能提高镇痛效果,并不会增加不良反应的发生,还可减少患者的镇痛药物用量、自控静脉镇痛泵按压次数。

Objective To explore the effect of different doses of hydromorphone combined with flurbiprofen axidate on self-controlled intravenous analgesia after cesarean section.Methods Ninety-eight women who completed cesarean section in Fuxin Central Hospital from March 2021 to February 2023 were selected as the study objects,and were divided into experimental group and control group according to random number table method,with 49 cases in each group.All patients underwent self-controlled intravenous analgesia after cesarean section.The control group was given conventional dose(0.10 mg/kg)of hydromorphone combined with flurbiprofen ester,and the experimental group was given high dose(0.30 mg/kg)of hydromorphone combined with flurbiprofen ester.The analgesia effects and adverse reactions of the two groups were recorded.Results VAS scores of 2 h,24 h and 48 h after surgery showed a decreasing trend,and visual analogue VAS scores of experimental group were significantly lower than those of control group at all time points after surgery,with statistical significance(P<0.05).There was no significant difference in Ramsay score at 2 h,24 h and 48 h after surgery between the two groups(P>0.05).There was no significant difference in the incidence of adverse reactions 48 h after operation between the experimental group and the control group(P>0.05).The dosage of analgesic drugs and the Times of self-controlled intravenous analgesia pump in experimental group were significantly lower than those in control group(P<0.05).Conclusion High-dose hydromorphone combined with flurbiprofen ester can improve the analgesic effect without increasing the occurrence of adverse reactions,and can also reduce the dosage of analgesic drugs and the number of self-controlled intravenous analgesic pump.