Analysis of Analgesic Effect of Hydromorphone During Mechanical Ventilation in Patients With Severe Traumatic Brain Injury
Objective To investigate the analgesic and sedative effects of hydromorphone during mechanical ventilation in patients with severe traumatic brain injury.Methods A total of 80 patients diagnosed with severe traumatic brain injury admitted to department of neurosurgery,Jinjiang Municipal Hospital/Shanghai Sixth People's Hospital Fujian Campus from April 2020 to April 2023 were selected as the study subjects.Patients treated with hydromorphone were selected as the group H,while patients treated with remifentanil were selected as the group R,with 40 patients each.Evaluation of horizontal time to reach critical-care pain observation tool(CPOT)criteria(CPOT score≤3 points),collect vital sign parameters and incidence of adverse events from two groups of patients before medication(T0)and 5 min(T1),30 min(T2),3 h(T3),24 h(T4),and 72 h(T5).Results The proportion of patients who achieved sedation level in T2,T3 and T4 in group H was 77.50%,77.50%and 100%,respectively,which was higher than 55.00%,55.00%and 90.00%in group R,and the difference was statistically significant(P<0.05).The heart rate(HR)of patients in group H at T1,T2,T3,T4 and T5 were(86.20±13.40),(83.72±9.11),(85.32±14.05),(87.32±14.92)and(84.88±11.21)times/min,respectively.It was higher than that of group R(80.00±9.23),(68.33±9.56),(79.65±10.74),(81.36±10.53),(80.17±11.05)times/min,and the difference was statistically significant(P<0.05).The mean artery press(MAP)of patients in group H at T1,T2,T3,T4 and T5 were(89.52±19.58),(88.53±14.26),(89.13±16.38),(88.47±15.48),(89.64±31.68)mmHg,respectively.It was higher than that of group R(73.13±13.21),(75.97±9.43),(79.50±13.51),(81.40±8.64),(80.18±6.31)mmHg,and the difference was statistically significant(P<0.05).The ejection fraction(EF)of patients in group H at T1,T2,T3,T4 and T5 were(61.20±9.28),(60.70±8.80),(62.40±9.50),(61.80±9.80),and(62.40±9.40)%,respectively.It was higher than that of group R(55.30±8.20),(54.80±6.20),(55.30±8.60),(56.20±7.40),(56.30±8.40)%,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusion Hydromorphone has a rapid effect on mechanical ventilation analgesia in patients with severe head injury,and has little impact on hemodynamics and respiratory inhibition.
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