Effect of patient-controlled intravenous analgesia with esketamine mixed with hydromorphone on postoperative sleep quality in pediatric patients
10.3760/cma.j.cn131073.20240226.00610
- VernacularTitle:艾司氯胺酮混合氢吗啡酮自控静脉镇痛对患儿术后睡眠质量的影响
- Author:
Yang LI
1
;
Liwei LI
;
Kun LIU
;
Zhonghua XIE
;
Lingling WANG
;
Chunyu MA
;
Jianjun YANG
Author Information
1. 郑州大学第一附属医院麻醉与围手术期及疼痛医学部，郑州 450000
- Keywords:
Cyclohexanes;
Hydromorphone;
Analgesia, patient-controlled;
Child;
Sleep quality
- From:
Chinese Journal of Anesthesiology
2024;44(6):698-701
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of patient-controlled intravenous analgesia (PCIA) with esketamine mixed with hydromorphone on the postoperative sleep quality in pediatric patients.Methods:This was a prospective randomised controlled study. One hundred pediatric patients of both sexes, aged 4-12 yr, with a body mass index of 13-26 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing elective abdominal surgery with general anesthesia, who agreed to use postoperative patient-controlled intravenous analgesia in our hospital from January to November 2023, were divided into esktamine mixed with hydromorphone group (EH group) and hydromorphone group (H group), with 50 patients in each group. PCIA solution contained esketamine 1 mg/kg and hydromorphon 0.1 mg/kg in 100 ml of 0.9% sodium chloride in EH group and hydromorphone 0.2 mg/kg in 100 ml of 0.9% sodium chloride in H group. The Pittsburgh Sleep Quality Index was used to evaluate the preoperative sleep quality by asking pediatric patients themselves or their guardians. On the morning of 1-3 days after surgery, the numeric rating scale (NRS) was used to evaluate the sleep quality of the first 3 nights after surgery. At 24 and 48 h after surgery, the FLACC pain scale was used to evaluate the intensity of pain. The consumption of hydromorphone within 48 h after surgery and the incidence of postoperative adverse reactions such as nausea, vomiting, itching and delirium were recorded. Results:Compared with group H, the NRS score was significantly increased on the 1st postoperative night, the ratio of poor sleep quality was decreased ( P<0.05), and no significant change was found in the NRS score on the 2nd or 3rd postoperative night and ratio of poor sleep quality ( P>0.05), and the FLACC pain scale score at 24 and 48 h after surgery and consumption of hydromorphone within 48 h after surgery were decreased in group EH ( P<0.05). There was no significant difference in the incidence of postoperative adverse reactions between the two groups ( P>0.05). Conclusions:PCIA with esketamine mixed with hydromorphone can improve the postoperative sleep quality in pediatric patients.
