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目的探讨盐酸氢吗啡酮用于儿童术后静脉自控镇痛(PCA)的临床应用效果。方法全麻术后接受48小时氢吗啡酮静脉自控镇痛的病人280例,年龄1~14岁,收集急性疼痛服务小组(acute pain service,APS)术后随访数据,包括术后4~8小时(T_1)、10~14小时(T_2)、22~26小时(T_3)、46~50小时(T_4)四次随访时病人的疼痛评分、用药剂量、PCA按压次数、镇静评分、不良反应、处理措施,以及T4时刻病人和家属满意度。结果 1~7岁儿童术后4次随访的FLACC(The Faces,Legs,Activity,Cry and Consolability Scale,0~100)疼痛评分为(7.89±11.01)、(8.58±9.83)、(6.27±6.54)、(2.58±5.14);8~14岁儿童4次随访静止VAS评分为(6.99±6.58)、(3.74±7.17)、(3.86±6.71)、(1.89±4.17),活动VAS评分为(14.40±9.24)、(9.46±10.39)、(7.73±9.66)、(8.27±7.94);各随访时刻Ramsay镇静评分为2,48小时内恶心呕吐率为8.22%,无呼吸抑制、过度镇静、皮肤瘙痒等不良反应,术后镇痛满意度为5。结论盐酸氢吗啡酮PCA用于儿童术后镇痛效果良好,不良反应发生率低。
Objective To investigate the clinical effect of hydromorphone hydrochloride for postoperative intravenous controlled analgesia (PCA) in children. Methods Two hundred and eighty-eight patients with controlled intravenous hydromorphone intravenous anesthesia 48 hours after general anesthesia were enrolled. The patients were aged from 1 to 14 years. Postoperative follow-up data of acute pain service (APS) were collected, including postoperative 4 to 8 hours Pain score, dosage, the number of PCA press, sedation score, adverse reaction, treatment at four follow-up visits of T_1, T_2, T_2 ~ T22, T46 ~ Measures, and satisfaction of patients and their families at T4. Results The pain scores of FLACC (The Faces, Legs, Activity, Cry and Consolability Scale, 0 ~ 100) in children aged 1 to 7 years after operation were (7.89 ± 11.01), (8.58 ± 9.83) and (6.27 ± 6.54) , (2.58 ± 5.14), respectively. The VAS score was (6.99 ± 6.58), (3.74 ± 7.17), (3.86 ± 6.71) and (1.89 ± 4.17), respectively 9.24), (9.46 ± 10.39), (7.73 ± 9.66) and (8.27 ± 7.94), respectively. Ramsay sedation score was 8.22% within 2,48 hours at each follow-up time without respiratory depression, over-sedation and pruritus Adverse reactions, postoperative analgesia satisfaction was 5. Conclusion Hydromorphone Hydrochloride PCA is effective in postoperative analgesia in children with low incidence of adverse reactions.