氢吗啡酮围术期镇痛的研究进展

Research Progress of Perioperative Analgesia with Hydromorphone

摘要: 氢吗啡酮作为一种合成的阿片受体激动剂，在围术期镇痛方面展现出了相较于传统阿片类药物更高的安全性和更低的依赖性。它通过激活中枢神经系统中的阿片受体来发挥镇痛作用，其特点在于拥有较长的半衰期和选择性，这使得它能有效降低术后疼痛评分以及减少常规镇痛药物的需求。此外，采用超前镇痛策略的氢吗啡酮应用，不仅能显著降低术后认知功能障碍的风险，还能减轻应激反应，改善术后睡眠质量，并减少术后并发症的风险。然而，关于氢吗啡酮长期应用的安全性以及最佳给药方案，目前还需要更深入的研究来探讨。未来的研究应当重点关注个体化给药策略的研究、长期使用的安全性评估，以及新型镇痛技术与多模式镇痛策略的开发，这些都是为了优化氢吗啡酮在临床上的应用，从而提高围术期镇痛的安全性和有效性。

Abstract: Hydromorphone, as a synthetic opioid receptor agonist, has demonstrated higher safety and lower dependence compared to traditional opioid drugs in perioperative analgesia. It exerts its analgesic effect by activating opioid receptors in the central nervous system. Its characteristics include a longer half-life and selectivity, which effectively reduce postoperative pain scores and the demand for conventional analgesics. Moreover, the application of hydromorphone in preemptive analgesia strategies not only significantly reduces the risk of postoperative cognitive dysfunction, but also alleviates stress responses, improves postoperative sleep quality, and reduces the risk of postoperative complications. However, further research is needed to explore the long-term safety of hydromorphone and the optimal dosing regimen. Future studies should focus on individualized dosing strategies, long-term safety evaluations, and the development of new analgesic technologies and multimodal analgesic strategies. These efforts aim to optimize the clinical application of hydromorphone, thereby enhancing the safety and effectiveness of perioperative analgesia.