Yu Dan, Hu Shaofei, Tian Meijun
Department of Pediatric General Surgery, Qingdao Women and Children's Hospital, 266034 Qingdao, Shandong, China.
Drug Supply Department, Yantai Yuhuangding Hospital, 264001 Yantai, Shandong, China.
Arch Esp Urol. 2025 Jun;78(5):555-561. doi: 10.56434/j.arch.esp.urol.20257805.75.
Wilms tumour is more common in children and ranks first amongst paediatric kidney tumours. This study aimed to evaluate the analgesic efficacy and safety of hydromorphone hydrochloride in postoperative pain management in children undergoing Wilms tumour operation.
A retrospective analysis was conducted to collect data on patients who were initially diagnosed and treated in the Paediatric Surgery Department of Yantai Yuhuangding Hospital from January 2020 to June 2024. According to the different postoperative analgesic methods, the children were divided into an observation group (n = 79, intravenous hydromorphone hydrochloride, 3 µg/(kgꞏh)) and a control group (n = 75, intravenous morphine hydrochloride, 15 µg/(kgꞏh)). The mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), peripheral oxygen saturation (SpO), face, legs, activity, cry, and consolability (FLACC) pain score, and Ramsay Sedation Scale (RSS) were evaluated at four time nodes after Post-Anaesthesia Care Unit (PACU), 6 h after operation, 24 h after operation, and 48 h after operation.
Repeated measures analysis of variance (ANOVA) showed a significant interaction effect between time and group on FLACC and RSS scores ( < 0.001), with significant main effects of time and group on FLACC and RSS scores ( < 0.001). The observation group had lower FLACC and RSS scores than the control group at 6 and 24 h postoperatively ( < 0.001). Additionally, a significant interaction effect existed between time and group on RR ( = 0.008), with significant main effects of time and group on HR and RR ( < 0.001). Time had a significant main effect on MAP and SpO ( < 0.05). The observation group had lower HR and RR values than the control group at 6 and 24 h postoperatively ( < 0.05). The incidence of adverse reactions in the observation group was lower than that in the control group during the observation period at 48 h after surgery ( < 0.05).
Hydromorphone hydrochloride can be used for postoperative pain management in paediatric patients with Wilms tumour. It has a good effect on postoperative pain improvement, sedation, and safety assurance in children.
肾母细胞瘤在儿童中更为常见，在小儿肾肿瘤中排名第一。本研究旨在评估盐酸氢吗啡酮在接受肾母细胞瘤手术的儿童术后疼痛管理中的镇痛效果和安全性。
进行回顾性分析，收集2020年1月至2024年6月在烟台毓璜顶医院小儿外科初诊并接受治疗的患者数据。根据术后不同的镇痛方法，将患儿分为观察组（n = 79，静脉注射盐酸氢吗啡酮，3 µg/(kg·h)）和对照组（n = 75，静脉注射盐酸吗啡，15 µg/(kg·h)）。在麻醉后监护病房（PACU）后、术后6小时、术后24小时和术后48小时这四个时间节点评估平均动脉压（MAP）、心率（HR）、呼吸频率（RR）、外周血氧饱和度（SpO）、面部、腿部、活动、哭闹及安慰度（FLACC）疼痛评分和 Ramsay 镇静评分（RSS）。
重复测量方差分析显示，时间和组间在FLACC和RSS评分上存在显著的交互作用（< 0.001），时间和组间对FLACC和RSS评分有显著的主效应（< 0.001）。观察组术后6小时和24小时的FLACC和RSS评分低于对照组（< 0.001）。此外，时间和组间在RR上存在显著的交互作用（= 0.008），时间和组间对HR和RR有显著的主效应（< 0.001）。时间对MAP和SpO有显著的主效应（< 0.05）。观察组术后6小时和24小时的HR和RR值低于对照组（< 0.05）。术后48小时观察期内，观察组不良反应发生率低于对照组（< 0.05）。
盐酸氢吗啡酮可用于小儿肾母细胞瘤患者的术后疼痛管理。它对儿童术后疼痛改善、镇静及安全保障有良好效果。
