Efficacy And Safety Of Different Doses Of Hydromorphone For Elderly Patients After Laparoscopic Bowel Surgery

Objective Colorectal cancer is one of the common malignant tumors of the digestive system in the elderly.With the development of accelerated rehabilitation surgery,most clinicians still recommend laparoscopic surgery as the preferred surgical method for elderly patients with colorectal malignant tumors.Postoperative pain in elderly patients is a very common symptom.It is the body's stress response to noxious stimuli,which causes the body's physiological environment to be disordered.This article explores the different doses of Hydromorphor(HM)for analgesia after laparoscopic bowel surgery in the elderly,and observes its effectiveness and safety.Methods:Eighty patients,aged from 65 to 79,who were scheduled for selective laparoscopic bowel surgery,were randomly divided into group A(hydromorphone 0.03 mg/kg,n=20),group B(hydromorphone 0.04 mg/kg,n=20),group C(hydromorphone 0.05mg/kg,n=20)and group D(Sufentanil 0.25ug/kg).Hydromorphone was intravenously injected at thirty minutes before the surgery ends.The recovery time of spontaneous respiration,time of eye opening and extubation time were recorded,Visual analog scale(VAS)and adverse effect at the time of 15 min,30 min,1 h,2 h after surgery were also recorded.Results:There were no significant differences in spontaneous breathing recovery time,eye opening time,and extubation time between the four groups(P> 0.05).Comparison of VAS scores at various time points after surgery,the VAS scores of groups B and C were lower than those of group A,The VAS scores of group C at T1,T2,and T3 were lower than those of group D,and the VAS of group B at T1 was lower than that of group D,The differences are statistically significant(P <0.05).The adverse reactions of the four groups of patients were compared.One patient in group B had nausea,six patients in group C had nausea,and five patients in group D had nausea.The number of nausea in group B was statistically significant with those in groups C and D(P < 0.05);there were no cases of vomiting in group A and group B,3 cases of vomiting in group C and 1 case of vomiting in group D.There was no significant difference in vomiting among the four groups(P> 0.05).Three patients in group A used salvage analgesics,no rescue analgesics were used in groups B and C,and five patients in group D used salvage analgesics,the difference between group B and group D was statistically significant(P <0.05)Conclusion: A single intravenous injection of hydromorphone 0.04 mg / kg 30 minutes before the end of the operation is an appropriate dose for single analgesia after laparoscopic bowel surgery in the elderly.