关键词: 氢吗啡酮, 静脉自控镇痛, 皮下注射, 口腔肿瘤, 术后镇痛

Abstract: PURPOSE: To compare pain control effect and safety of hydromorphone patient-controlled intravenous analgesia (PCIA) and subcutaneous injection for patients after oral tumor surgery. METHODS: A total of 200 patients after oral tumor surgery from January 2022 to March 2023 in Shanghai Ninth People's hospital were selected and divided into two groups according to the random number table method (control group, n=100, who received subcutaneous injection of hydromorphone; experimental group, n=100, who received hydromorphone PCIA). Chinese version of the brief pain inventory(BPI-C), serum markers [prostaglandin E2 (PGE2), 5-hydroxytryptamine (5-HT), nitric oxide (NO), and growth hormone (GH) ], expression levels of inflammatory factors [serum tumor necrosis factor-α, (TNF-α), interleukin 6 (IL-6), interleukin 1β (IL-1β)], sleep quality [insomnia severity index (ISI)], and the incidence of adverse reactions were compared between the two groups. SPSS 23.0 software package was used for data analysis. RESULTS: Forty-eight hours after surgery, BPI-C score of the experimental group including current pain degree, average pain degree, most painful pain degree in the past 24 hours, least painful pain degree in the past 24 hours, pain relief degree after pain treatment in the past 24 hours, and the levels of PGE2, 5-HT, NO, GH, Cor, PRL, TNF-α, IL-6 and IL-1β were significantly lower than those of the control group(P<0.05). One week after surgery, ISI scores in the experimental group were significantly lower than those in the control group(P<0.05). The incidence of adverse reactions was 10.00% in experimental group and 13.00% in control group, with no significant difference (P>0.05). CONCLUSIONS: Application of hydromorphone PCIA in postoperative patients with oral tumors can not only effectively relieve the pain perception of patients, but also reduce the expression of pain mediators and inflammatory factors in serum, thus alleviating the stress response. It can also help improving the sleep quality of patients, while not increase the occurrence of adverse reactions. So it is worthy of clinical application.

Key words: Hydromorphone, Intravenous controlled analgesia, Subcutaneous injection, Oral tumor, Postoperative analgesia