[Efficacy of patient-controlled intravenous analgesia with hydromorphone hydrochloride plus flurbiprofen axetil after endoscopic sinus surgery].

Objective: To evaluate the efficacy of patient-controlled intravenous analgesia (PCIA)with hydromorphone hydrochloride plusflurbiprofen axetil after endoscopic sinus surgery(ESS). Methods: One hundred patients of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for ESS under total intraveous anesthesia with postoperative PCIA in Beijing Tongren Hospital from October 2015 to April 2016 were randomly divided into 3 groups according to the different formula of PCIA pumpin each group: Group A (hydromorphone hydrochloride 1 µg·kg(-1)·h(-1)+ flurbiprofen axetil 200 mg), Group B(hydromorphone hydrochloride 2 µg·kg(-1)·h(-1)), Group C( hydromorphone hydrochloride 1 µg·kg(-1)·h(-1)). The dosage of PCIA in each group was calculated for 50 h, and was diluted in 100 ml normal saline. All the pump was set up background infusion at a rate of 2 ml/h with a 2 ml bolus dose and a 15 min lock-time.Visual analogue scale (VAS) and Ramsay sedation scores at time points of postoperative 1, 4, 8, 12, 24, 48 h, the number of attempts to press bolus and rate of adverse effects within 48 h were recorded. The differences were compared among the groups. Results: VAS at postoperative 1, 4, 8, 12 h in Group A was (1.9±0.6), (1.8±0.6), (1.6±0.6), and (1.2±0.4) respectively, in Group B was (1.8±0.4), (1.7±0.7), (1.6±0.6), and (1.3±0.5) respectively, in Group C was (2.5±0.9), (1.7±0.7), (1.6±0.6), and (1.3±0.5) respectively. The difference among each group were statistically significant (F=8.661, 3.105, 4.903, 13.846, P<0.05). VAS in Group A was similar to that in Group B(P>0.05), but was lower than that in Group C(P<0.05). The number of attempts to press bolus within 48 h in group A was 1.4±1.0, which was less than in Group C(2.2±1.8 , P<0.05). Ramsay sedation score at postoperative 1, 4, 8 h in Group A was (2.4±0.6), (2.2±0.6), and (2.2±0.4) respectively, in Group B was (2.8±0.7), (2.6±0.7), and (2.4±0.6) respectively, in Group C was (2.3±0.6), (2.1±0.4), and (2.1±0.2) respectively. The difference among each group were statistically significant (F=5.660, 6.782, 7.141, P<0.05). Ramsay sedation score in group A was similar to that in Group C(P>0.05), but was lower than that in Group B(P<0.05). The total rate of adverse effects in Group A was 8.8%, which was similar to that in Group C (9.1%, χ(2)=0.001, P>0.05), but was significantly lower than that in Group B (42.5%, χ(2)=9.99, P<0.05). Conclusion: 1 µg·kg(-1)·h(-1) hydromorphone hydrochloride plus 200 mg flurbiprofen axetil is effective on PCIA for patients after ESS and can reduce the dosage of hydromorphone hydrochloride and the rate of adverse effects as well.

Drug use patterns and gender differences among heroin addicts hospitalized for detoxification.

BACKGROUND: There has been a surge of heroin abuse in Taiwan in recent years making it necessary to study and understand the characteristics, drug use patterns and behavior among heroin users. MATERIALS AND METHODS: Two hundred and eighty-three patients hospitalized for heroin detoxification received a diagnostic interview and a semi-structured interview which rendered the demographic information, medical history, and patterns of and reasons for heroin use. Differences between male and female drug users were also compared. RESULTS: More than half of the subjects (54.3%) were unemployed. The percentage of unemployment of female patients was significantly greater than that of male patients (75.9% vs. 48.0%, p<0.05). Women were significantly younger (p<0.001) and had a significantly earlier (p< 0.001) onset of heroin use than men. About one-third of the subjects (33.9%) were multiple drug users, with amphetamines as the most common (79.2%) concomitant drug of abuse. More men reported curiosity as the reason for first use, while more women reported peer influence as the reason for first use. CONCLUSION: This study showed that significant gender differences in employment status, age of first use, and reasons for drug use among heroin addicts. Further exploration of gender and cross-cultural differences could have important theoretical and treatment implications.