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首页> 外文期刊>Current therapeutic research, clinical and experimental. >Novel Use of Hydromorphone as a Pretreatment Agent: A Double-blind, Randomized, Controlled Study in Adult Korean Surgical Patients
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Novel Use of Hydromorphone as a Pretreatment Agent: A Double-blind, Randomized, Controlled Study in Adult Korean Surgical Patients

机译：氢吗啡酮作为预处理剂的新型用途：对成年韩国手术患者的双盲，随机对照研究

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BACKGROUND: Hydromorphone is a potent mu.-opioid selective agonist that has an onset time within 5 minutes and reaches peak effect between 10 and 20 minutes. However, it may show immediate analgesic effect to rocuronium-induced pain because of its peripheral analgesic property and also may attenuate noxious stimuli from tracheal intubation during induction. The opioid receptors are known to be present in peripheral sensory nerve terminals as well as in the dorsal root ganglion and the central terminal of primary afferent nerves. Therefore, we hypothesized that hydromorphone may be considered a potent pretreatment or adjuvant drug during the induction of anesthesia with its peripherally and centrally mediated analgesia.OBJECTIVE: The aim of this study was to compare the effects of pretreatment with hydromorphone in reducing rocuronium-induced withdrawal movements and hemodynamic changes during tracheal intubation with the effects of fentanyl and normal saline.METHODS: In this double-blind, randomized, controlled study, consecutive adult patients aged 20 to 70 years who were scheduled to undergo general anesthesia for elective gastric or colorectal surgery at the Samsung Seoul Hospital (Seoul, Republic of Korea) were randomly assigned to receive 5 mL hydromorphone 0.03 mg/kg or fentanyl 2 mug/kg or normal saline. Thirty seconds after administering the study drug, anesthesia was induced with 2.5% thiopental sodium 5 mg/kg. After loss of consciousness, rocuronium 0.6 mg/kg was injected and immediate withdrawal movements were recorded. Two minutes after rocuronium injection, tracheal intubation was performed and hemodynamic changes were observed.RESULTS: A total of 194 patients were enrolled, with 65 in the hydromorphone group, 67 in the fentanyl group, and 62 in the saline group. The overall incidence of withdrawal movements was significantly lower in the hydromorphone group (2 patients; 3.1%) and the fentanyl group (5 patients; 7.5%) (both, P < 0.001) than in the sa...
机译：背景：氢吗啡酮是一种强效的μ阿片类选择性激动剂，起效时间在5分钟内，并在10至20分钟之间达到峰值。然而，由于其外围镇痛特性，它可能对罗库溴铵所引起的疼痛立即显示出镇痛作用，并且还可能减弱诱导过程中气管插管产生的有害刺激。已知阿片样物质受体存在于周围感觉神经末梢以及背根神经节和初级传入神经的中央末梢。因此，我们假设氢吗啡酮在麻醉过程中可以通过周围和中央介导的镇痛被认为是一种有效的预处理或辅助药物。目的：本研究的目的是比较氢吗啡酮预处理在减少罗库溴铵引起的戒断中的作用。方法：在芬太尼和生理盐水的作用下，气管插管期间的运动和血流动力学变化。方法：在这项双盲，随机，对照研究中，连续20至70岁的成年患者计划接受全身麻醉以进行选择性胃或结直肠手术在三星首尔医院（大韩民国首尔）随机分配5 mL氢吗啡酮0.03 mg / kg或芬太尼2杯/ kg或生理盐水。给予研究药物30秒后，以2.5％硫喷妥钠5 mg / kg诱导麻醉。失去知觉后，注射罗库溴铵0.6 mg / kg，并记录立即撤药运动。罗库溴铵注射后2分钟，行气管插管并观察到血流动力学变化。结果：总共入组194例患者，其中氢吗啡酮组65例，芬太尼组67例，生理盐水组62例。氢吗啡酮组（2例; 3.1％）和芬太尼组（5例; 7.5％）（两者，P <0.001）的撤药运动的总发生率均显着低于药物治疗组。

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