摘要
目的探讨静脉注射氢吗啡酮用于妇科腹腔镜手术超前镇痛中的效果及其不良反应发生情况。方法 选择我院择期行妇科腹腔镜手术的60例患者（ASAⅠ-Ⅱ级）,随机分为H组和C组,各30例。C组在缝皮前不予任何镇痛药,H组缝皮前15 min静脉注射氢吗啡酮0.01 mg/kg。两组患者分别于术后1 h（T1）、4 h（T2）、8 h（T3）采集VAS、BCS评分,当患者的VAS评分为10分,BCS评分为0级时,以哌替啶50 mg肌注镇痛,并记录术后初次使用哌替啶的时间及使用次数、例数,随访记录不良反应的发生率。结果 H组术后T2、T3时点的VAS评分明显低于C组,而BCS评分明显高于C组（P〈0.05）;H组术后使用哌替啶例数及次数低于C组,哌替啶的初次使用时间长于C组（P〈0.05）;H组和C组咽喉疼痛发生率分别为6.7%和53.3%（P〈0.05）;两组的不良反应中头昏嗜睡和恶心呕吐的比较,差异无统计学意义（P〉0.05）。结论 氢吗啡酮用于妇科腹腔镜手术的超前镇痛,对术后切口疼有显著镇痛效果,且可减少术后静脉镇痛药用量,减少不良反应的发生,患者术后苏醒安全迅速。
Objective To investigate the effect and safety of preemptive analgesia with hydromorphone in gynaecological laparoscopic surgery through intravenous injection. Methods 60 female adult patients（ASA I or H ）who underwent the gynaecological laparoscopic surgery were randomly divided into two groups（30 cases of each group）： hydromorphone group（group H） and placebo group（group C）.Patients in group C were not given any analgesics before suture. Patients in group H were given 0.01 mg/kg hydromorphone through intravenous injection before suture,the interval was 15 minutes. After operation,the pain of incision was assessed by VAS and BCS scores at 1 h（Tl）,4 h（T2） and 8 h（T3） respectively. When the VAS scores reached 10 and the BCS score was 0,patients were given intramuscular administration of 50 mg meperidine to relieve the pain.The time used and intervals of meperidine,the cases of using meperidine, and the incidence of sore throat in patients were recorded. Results The VAS scores of patients at T2 and T3 after operation in group H were significantly lower than that of group C, while the BCS scores were higher than that of group C （P〈0.05） ; The times of using meperidine, and the cases of using meperidine in group H were lower than those in group C, the initial use time of meperidine of group H was longer than that of group C （P〈0.05）. The incidence of sore throat was lower in group H than that of group C（6.7% vs 53.3%）（P〈0.05）, while there were no differences between the two groups in the incidence of vomiting and nausea（P〉0.05）. Conclusion Preemptive analgesia with hydmmorphone can lighten the postoperative pain effectively, it can also reduce the usage of analgesics and adverse reactions, and has the advantages of safety and promote a faster recovery.
出处
《中国现代医生》
2016年第24期135-137,共3页
China Modern Doctor
关键词
氢吗啡酮
超前镇痛
妇科
腹腔镜
Hydromorphone
Preemptive analgesia
Gynecology
Laparoscopy
