The Clinical Research Of Hydromorphone Patient Controlled Intravenous Analgesia After Intestinal Resection

Objectives: Perioperative acute pain is a very important problem.Regardless of the type or method of operation,pain management is very necessary that it can alleviate pain and make patients active as early as possible.It also can shorten the hospitalization period,reduce hospital costs and improve patient satisfaction.The main aim of perioperative acute pain management is adequate analgesia and reducing the postoperative chronic pain caused by the improper cure of acute pain.The purpose of this study was to compare the effect and safety of patient controlled intravenous analges with morphine and hydromorphine in postoperative analgesia.Methods: 80 patients who required PCIA after intestinal resection ware injected 5mg morphine or 1 mg hydromorphine 15 minutes before the end of the surgery.The drugs were the same in PCIA except morphine and hydromorphine,all cases were randomly divided into two groups:group morphine(Group M)and group hydromorphine(Group HM).The clinical research recorded the the vital signs,the dosage of fentanyl,anesthesia recovery time and anesthesia recovery score in the PACU(Postanesthesia care unit).Patients went back to the ward after recovery.The vital signs,VAS(Visual analogue scales),and adverse reactions such as number of nausea and vomiting were observed and recorded 2,4,6,12,24,36and48 hours after operation.Main Results: The differences in gender,age,weight and operation time between Group M and Group HM were not statistically significant(P>0.05).Compared with Group M,the time of extubation were significantly prolonged in Group HM(P <0.05).5% of the patients in Group HM felt different level of pain,dosage of fentanyl(30±14)?g.25% of the patients in Group M felt pain of different degrees,dosage of fentanyl(39±18)?g.The incidence of pain in Group HM was statistically lower than that in Group HM(P<0.05).The VAS score 2,4hours after operation in group HM was significantly lower than in the Group M(P<0.05),Ramsay sedationscore in group HM was significantly higher than that in group M(P<0.05).The VAS score and Ramsay sedation score 8h after operation were no significant difference between two groups(P > 0.05),The differences in incidence of nausea,vomiting,dizziness,sleepiness and adverse reactions 24 hours after operation between two groups were not statistically significant.(P>0.05).Conclusions:Hydromorphine is more effective in reducing the explosive pain after the fentanyl injection pump was stopped and postoperative pain than morphine,but the time of tracheal extubation and anesthesia recovery time is longer.Compared with morphine,hydromorphine do not increase the postoperative respiratory depression,the incidence of nausea,vomiting and other adverse reactions of postoperative analgesia,it can be used in clinical practice safely.