Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
Department of Anesthesiology and Department of Nursing Education, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
J Perianesth Nurs. 2024 Oct;39(5):902-906. doi: 10.1016/j.jopan.2023.12.031. Epub 2024 Jun 12.
The aim of this study was to compare the analgesic effect and adverse events of hydromorphone patient-controlled intravenous analgesia (PCIA) without background dose versus sufentanil PCIA with background dose in patients after surgery.
A retrospective analysis.
From June 2020 to May 2021, 1,594 eligible postoperative patients who received PCIA were included in this study. According to the types of opioids, patients were divided into two groups: the sufentanil group and the hydromorphone group. The Numerical Rating Scale, Functional Activity Scale, and Level of Sedation were used to evaluate the analgesic effects between the two groups. In addition, total patient-controlled analgesia (PCA) use, effective number of PCA compressions, and adverse effects of PCIA were compared between the two groups.
At 24 hours (h) after surgery, the Functional Activity Scale score in the sufentanil group was higher than that in the hydromorphone group (P < .05). Compared with the sufentanil group, total PCA use, total number of PCA compressions and effective number of PCA consumptions were significantly decreased in the hydromorphone group during a 48 hours period (P < .05). There were no statistical differences in Numerical Rating Scale score, Level of Sedation score, and adverse events between two groups at 24 hours and 48 hours after surgery.
Compared with sufentanil PCIA with a background dose, under a similar analgesic effect, hydromorphone PCIA without a background dose provided lower PCA use. Our findings may provide useful evidence for more future studies related to postoperative analgesia.
本研究旨在比较无背景剂量氢吗啡酮患者自控静脉镇痛（PCIA）与有背景剂量舒芬太尼 PCIA 在术后患者中的镇痛效果和不良反应。
回顾性分析。
本研究纳入了 2020 年 6 月至 2021 年 5 月期间接受 PCIA 的 1594 例符合条件的术后患者。根据阿片类药物的类型，患者分为两组：舒芬太尼组和氢吗啡酮组。采用数字评分量表、功能活动量表和镇静水平评估两组的镇痛效果。此外，比较两组患者的总 PCIA 用量、PCA 按压次数和 PCIA 不良反应。
术后 24 小时，舒芬太尼组的功能活动量表评分高于氢吗啡酮组（P <.05）。与舒芬太尼组相比，氢吗啡酮组在 48 小时内总 PCA 用量、总 PCA 按压次数和有效 PCA 消耗量明显减少（P <.05）。两组患者术后 24 小时和 48 小时的数字评分量表评分、镇静水平评分和不良反应无统计学差异。
与有背景剂量舒芬太尼 PCIA 相比，在类似的镇痛效果下，无背景剂量氢吗啡酮 PCIA 可减少 PCA 的使用。我们的研究结果可能为术后镇痛相关的进一步研究提供有用的证据。
