Liu Jitong, Wang Yongsheng, Tang Yixun, Luo Jia, Long Yi, Tan Suhong
Department of Anesthesiology, Hunan Provincial People's Hospital, Changsha, Hunan 410005, P.R. China.
Oncol Lett. 2020 Dec;20(6):296. doi: 10.3892/ol.2020.12159. Epub 2020 Sep 25.
The present study aimed to explore the clinical efficacy and safety of hydromorphone combined with sufentanil in patient-controlled intravenous analgesia (PCIA) for patients with hepatocellular carcinoma (HCC) and its effect on serum immune factors in serum. Data from 385 patients with HCC, admitted to the Hunan Provincial People's Hospital (Changsha, China) from February 2015 to September 2018, were retrospectively analyzed. Laparoscopic hepatectomy was performed in all patients. A total of 180 patients who received PCIA were treated with sufentanil (control group), and 205 patients who received PCIA were treated with hydromorphone and sufentanil (study group). PCIA was used after hepatocellular cancer operation. In the control group, the analgesic pump was filled with sufentanil (2 µg/kg) and tropisetron (5 mg), whereas in the study group, the analgesic pump was filled with sufentanil (2 µg/kg), tropisetron (5 mg) and hydromorphone (5 mg). Both groups of drugs were diluted into 100 ml with normal saline and the loading dose was 5 ml; the continuous dose was 2 ml/h and the single PCIA amount was 2 ml. The visual analogue scale (VAS) and numeric sedation scale (NSS) scores at 12 and 24 h after operation, as well as and satisfaction score at 24 h after operation, were recorded. The levels of CD3, CD4, CD8 lymphocytes and NK cells in the peripheral blood of patients were detected by flow cytometry. The postoperative hospitalization time, first flatulence time, first defecation time and first ambulation time, as well as the adverse reactions, were recorded. The results revealed that the satisfaction score of the patients at 24 h after operation was significantly higher in the study group than that in the control group (P<0.05). Additionally, there were no serious adverse reactions in either group. In conclusion, PCIA with hydromorphone and sufentanil can provide safe and effective analgesia, may improve the levels of immune factors and enhance the recovery ability of the patients.
本研究旨在探讨氢吗啡酮联合舒芬太尼用于肝细胞癌（HCC）患者自控静脉镇痛（PCIA）的临床疗效、安全性及其对血清免疫因子的影响。回顾性分析了2015年2月至2018年9月在湖南省人民医院（中国长沙）收治的385例HCC患者的数据。所有患者均行腹腔镜肝切除术。共有180例接受PCIA的患者接受舒芬太尼治疗（对照组），205例接受PCIA的患者接受氢吗啡酮和舒芬太尼治疗（研究组）。肝细胞癌手术后采用PCIA。对照组镇痛泵中加入舒芬太尼（2μg/kg）和托烷司琼（5mg），而研究组镇痛泵中加入舒芬太尼（2μg/kg）、托烷司琼（5mg）和氢吗啡酮（5mg）。两组药物均用生理盐水稀释至100ml，负荷剂量为5ml；持续剂量为2ml/h，单次PCIA量为2ml。记录术后12h和24h的视觉模拟评分（VAS）和数字镇静评分（NSS），以及术后24h的满意度评分。采用流式细胞术检测患者外周血中CD3、CD4、CD8淋巴细胞和NK细胞水平。记录术后住院时间、首次排气时间、首次排便时间和首次下床活动时间以及不良反应。结果显示，研究组患者术后24h的满意度评分显著高于对照组（P<0.05）。此外，两组均未出现严重不良反应。综上所述，氢吗啡酮联合舒芬太尼PCIA可提供安全有效的镇痛，可能提高免疫因子水平，增强患者的恢复能力。
