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Background: The efficacy and safety of continuous subcutaneous injection (CSCI) of hydromorphone hydrochloride (HM) for titration of moderate to severe cancer pain have yet to be evaluated. Methods: We retrospectively analyzed the patients underwent CSCI of HM from Feb. 2020 to Oct. 2021 in Kitano Hospital, Osaka, Japan. The concentration of HM was 0.20 mg/ml to 1.0 mg/ml in saline depending on the patient. Haloperidol was added to a concentration of 0.5 mg/ml for a total of 10 ml. CSCI was performed using a portable small syringe driver. The dose was titrated between 0.05 ml/h and 1.0 ml/h to achieve adequate relief of pain without unacceptable side effects. Results: A total of 37 patients including 1 opioid-naive patient were examined. The median dose of HM at the initiation and completion of titration was 1.92 and 2.40 mg/day, respectively. The median time to titration completion was 2 days. Titration completion rate within 3 days was observed in 33 patients (89%). Remarkable effect to pain (at least 66% improvement in numerical rating scale [NRS]) was observed in 33 patients (89%), efficacy (33 to 66% improvement in NRS) in 3 patients (8.1%), and inefficacy in 1 patient (2.7%). Adverse events included Common Terminology Criteria for Adverse Events Grade 2 drowsiness in 3 patients (8.1%) and Grade 2 hypotension in 1 patient (2.7%), both of which improved with reduction or discontinuation of HM. Conclusion: CSCI of HM was simple and safe, and produced rapid and effective pain control for moderate to severe cancer pain.
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Objective To explore the reasonable dose of hydromorphone hydrochloride in the elderly patients after hip surgery. Methods 120 cases of elderly patients who underwent total hip arthroplasty in Affiliated Hospital of Jiangsu University from April 2016 to July 2016 were divided into six groups randomely,with 20 cases each group,they were 0.020,0.035,0.050,0.065,0.080 and 0.095mg/mL group,the corresponding concentrations of HYD were given to each group after surgery,blood rheology, inflammatory cytokine, VAS and Ramsay sedation scores were observed at different time points, Complications were recorded. Results One day and three days after operation,whole blood viscosity and whole blood reduced viscosity level of six groups were significantly increased (P<0.05),with the increase of the concentration of HYD,whole blood viscosity and whole blood reducing viscosity of each group decreased,compared with 0.020-0.050 mg/mL group,the 0.065-0.095 mg/mL group was lower (P<0.05).One day and three days after operation,the levels of inflammatory cytokines were increased in six groups (P<0.05),with the increase of the concentration of HYD,the level of inflammatory factors decreased,compared with 0.020-0.050 mg/mL group,the 0.065-0.095 mg/mL group was lower (P<0.05).The VAS scores of six groups were decreased in different degree with the prolongation of time, with the increase of the concentration of HYD,VAS at different time after operation decreased to some extent (P<0.05),compared with 0.020-0.035 mg/mL group,the 0.050-0.095 mg/mL group was lower (P<0.05). Ramsay sedation scores increased in 0.020-0.035mg/mL group and decreased in 0.065-0.095mg/mL group,but no significant change in 0.050mg/mL group. The incidence of adverse reactions was the lowest in the 0.050 mg/mL group. Conclusion HYD can be used for postoperative analgesia in elderly patients undergoing hip joint surgery,the concentration of HYD was correlated with the analgesic efficiency, and the recommended concentration was 0.050 mg/mL.
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Objective To investigate the influence of preemptive analgesia with Hydr- omorphone Hy-drochloride on postoperative cognitive function and inflammation cytokines in the elderly patients. Methods Ninety ASA I orⅡ elder patients were randomly divided in control group (C)and Hydromorphone Hydrochloride group(H) with 45 cases each. Hydromorphone Hydrochloride 2 mg was injected iv before induction of anesthesia in group H. Observed plasma concentrations of the CRP、 TNF-α and IL-6 at different time. Cognitive function was assessed by minimental state examination. Results Plasma the CRP、 TNF-a and IL-6 concentrations were lower and MMSE scales were higher in group H than in group C. Conclusion Preemptive analgesia with Hy-dromorphone Hydrochloride 2 mg can reduce the incidence of postoperative cognitive dysfunction in the elderly patients.
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Objective To observe analgesia effect of morphine hydrochloride and hydromorphone hydrochloride in patients after transurethral resection of prostate. Methods Patients after transurethral resection of the prostate (TURP) were randomly divided into 2 groups, morphine hydrochloride group (n=45) and hydromorphone hydrochloride group (n=47). Analgesia, sedation efficacy and adverse reactions were evaluated at 6 and 24 h after they received epidural postoperative analgesia by using VAS score and Ramsay score. Results In 6 h, hydromorphone hydrochloride group had a better pain tolerance and feeling than morphine hydrochloride group (P0.05).There were no differences in adverse reactions between the two groups ( P>0. 05 ) . Conclusion Hydromorphone has a better effect than morphine in epidural analgesia in 6 h.