Randomized Controlled Trial Of Hydromorphone For Intravenous Analgesia In Paediatric Patients With Postoperative Pain

Objective:To study the application of hydromorphone for intravenous analgesia in paediatr ic patients who are undergoing orthopaedic surgery for developmental dislocation of the hip(DDH)and to evaluate its effectiveness and safety.Methods: A randomized,double-blinded,parallel-controlled,positive control design was used.A total number of seventy-six paediatric patients who were from 2 to 5 years old and who were undergoing elective DDH surgery under general anaesthesia were recruited to the study and divided into a sufentanil group(S,n=38)and a hydromorphone group(H,n=37).The same method of anaesthesia and 48 hours of parent-controlled intravenous analgesia therapy after surgery were received.Loading dose of either sufentanil(0.1 μg/kg)or hydromorphone(10 ug/kg)via venous before the end of surgery.Five minutes after the extubation,following the sufentanil(0.04μg·kg-1·h-1)or hydromorphone(4 μg·kg-1·h-1)was infused via an PCIA pump(basal rate,2mL/hr;bolus,0.5 m L;lock out interval,15 min).Additionally,we assessed the effect and safety of drugs on some outcomes,including the cough grade,paediatric anesthesia emergence delir i scores and other recovery profiles during the periextubation per iod.Pain scores,sunstance P,sedation scores,press times,analgesia consumption,parent satisfaction,adverse side effects and event frequency over time were evaluated,in both groups.Results:The mean arterial pressure was differ between the two groups during extubation time(P<0.05).The Narcotrend scores was significantly high in the hydromorphone group compared to that in the control group(P<0.05).There was no significant difference between two groups on extubation time,recovery time,emergence agitation and cough(P >0.05).The difference between the two groups’ sedation scores was statistically significant(P<0.05),with the hydromorphone group exceeding the sufentanil group in the ear ly stage.The hydromorphone group had fewer invalid press times than the sufentanil group(P<0.05).There was no signif icant difference in the pain scores,sunstance P and parents satisfaction between the groups and no difference in the incidence of side effects and events(P>0.05).Conclusion:A single does of hydromorphone(10 ug /kg)before the end of surgery during general anesthesia may be a better method for smooth recovery with stable vital signs.Hydromorphone may be a suitable alternative approach to parent-controlled intravenous analgesia in paediatric patients after orthopaedic surgery,providing adequate analgesia and fewer side effects.Severe sedation of hydromorphone be causing alarm,especially in the early stage.