Abstract：【Objective】To explore the effect of hydromorphone combined with tramadol on postoperative intravenous patient-controlled analgesia (PCIA) in patients with tuberculous empyema.【Methods】A total of 104 patients with tuberculous empyema were randomly divided into the control and the observation groups, with 52 cases in each group. Postoperatively, the control group received tramadol for PCIA, while the observation group received hydromorphone combined with tramadol for PCIA. The postoperative analgesic effect, respiratory and circulatory indicators, and cognitive function at different time points were compared between the two groups. Stress indicators [cortisol (Cor), C-reactive protein (CRP)] before and 18 h after surgery and the incidence of adverse reactions were also compared.【Results】The visual analog scale (VAS) pain scores at 6 h, 18 h, and 24 h postoperatively were higher than those at 3 h postoperatively in both groups (P<0.05). In both groups, the VAS scores at 18 h postoperatively were higher than those at 6 h postoperatively (P<0.05), while the VAS scores at 24 h postoperatively were lower than those at 18 h postoperatively (P<0.05). Compared to the control group, the VAS scores at 6 h, 18 h, and 24 h postoperatively were lower in the observation group (P<0.05). The postoperative CRP and Cor levels were higher than the preoperative levels in both groups, with the observation group showing lower levels than the control group (P<0.05). At 12 h postoperatively, the heart rate (HR) and respiratory rate (RR) were lower, and the oxygen saturation (SpO2) was higher in the observation group compared to the control group (P<0.05). Compared to preoperative levels, the Montreal Cognitive Assessment (MoCA) scores at 18 h postoperatively were lower in both groups (P<0.05), while the score of MoCA in the observation group was higher than that in the control group (P<0.05). Compared to MOCA scores at 18 h postoperatively, the MoCA scores at 24 h postoperatively were higher in both groups (P<0.05). There was no statistically significant difference in the MoCA scores between preoperative and 24 h postoperatively in both groups (P>0.05). The total incidence of adverse reactions was lower in the observation group, compared to the control group (P<0.05). 【Conclusion】The application of hydromorphone combined with tramadol for postoperative analgesia in patients with tuberculous empyema helps alleviate pain, reduces the impact on cognitive function, improves stress indicators, and reduces the incidence of adverse reactions.
叶霞, 王璐. 氢吗啡酮复合曲马多在结核性脓胸患者术后静脉自控镇痛中的应用效果[J]. 医学临床研究, 2024, 41(9): 1378-1381.
YE Xia, WANG Lu. Effect of Hydromorphone Combined with Tramadol on Postoperative Intravenous Patient-Controlled Analgesia in Patients with Tuberculous Empyema. JOURNAL OF CLINICAL RESEARCH, 2024, 41(9): 1378-1381.
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2024, Vol. 41 
