Hydromorphone Hydrochloride for Postoperative Pain Relief and Safety in Children Undergoing Wilms Tumour Operation: A Single-Centre Retrospective Study.

OBJECTIVE

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.