Abstract: 【Objective】 To investigate the efficacy of hydromorphone in postoperative analgesia. 【Methods】 Selected 120 patients undergoing hepatobiliary or gastrointestinal surgery of ASA I~II levels

were randomly and double-blindly divided into four groups (n = 30 each):VH group patients were treated by a bolus dose of normol saline 5 mL and hydromorphone 0.4 mg

continuously intravenous infusion with normal saline 100 mL and hydromorphone 3.6 mg; VM group were treated by a bolus dose normol saline 5 mL and morphine 2 mg

continuously intravenous infusion with normal saline 100 mL and morphine 18 mg; EH group were treated by a bolus dose of 0.25% ropivacaine 5 mL and hydromorphone 0.4 mg

continuously epidural pumping with 0.125% ropivacaine 100 mL and hydromorphone 1.6 mg; EM group were treated by a bolus does 0.25% ropivacaine 5 mL and morphine 2 mg

continuously epidural pumping with 0.125% ropivacaine 100 mL and morphine 8mg. All the analgesia pump speed 2 mL/h during 48 h. Then the respiration

circulation

sedation

pain scores and side effects were perioperatively monitored in all groups. 【Result】 Postoperative analgesia satisfaction reached 98%. Ramsey’s Sedation Scales are 2-3 scores belong to satisfied with sedation. SpO2 was significantly lower at 12

24

48 h after analgesia than that before analgesia in VH group (P < 0.05); SpO2 was significantly lower at 2 h after analgesia than that before analgesia in VM group (P < 0.05); R-VAS was significantly lower at 48 h than that at 6h after analgesia in VH group (P < 0.05); M-VAS was significantly lower at 24 h

48 h than that at 2 h

6 h after analgesia in VH group (P < 0.05); M-VAS was significantly lower at 6h than that at 2h after analgesia in VM group (P < 0.05); Compared with SBP before analgesia

there was significantly decrement at 2

6

12

24

48 h after analgesia in EH group (P < 0.05); HR was significantly higher at 12

24

48 h after analgesia than that before analgesia in EH group (P < 0.05); SpO2 was significantly lower at 6

12

24

48 h after analgesia than that before analgesia in EH group (P < 0.05); M-VAS was significantly lower at 48 h than that at 2 h after analgesia in EH group (P < 0.05); Compared with DBP of VH group

there was significantly decrement at 24 h

48 h after analgesia in EH group (P < 0.05). There was no signify difference in the rate of nausea and vomiting among four group (P > 0.05). The incidence of pruritus in epidural group was higher than that in patients with intravenous administration (P < 0.05). The rate of drowsiness in EM group and VH group was higher than that of EH group (P < 0.05). The rate of dizzy in EM group and VM group was respectively higher than that of EH group and VH group (P < 0.05). 【Conclusion】 This study found hydromorphone to be at least as effective as morphine when delivered by continuous intravenous or epidural infusion in postoperative analgesia

and side effects may be less.