羟考酮与舒芬太尼用于肺叶切除术患者术后静脉自控镇痛的比较  

A comparison of patient controlled intravenous analgesia with oxycodone and sufentanil for pulmonary lobectomy

作　　者：马玉恒[1] 刘中光 李永旺[1] 刘帆[1] 张树峰[1] 陈阳[1] 韩月鹏[1] 

机构地区：[1]北京第二炮兵总医院麻醉科,100088

出　　处：《中华临床医师杂志（电子版）》2015年第6期53-56,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的比较盐酸羟考酮注射液与枸橼酸舒芬太尼注射液用于开胸肺叶切除手术后静脉患者自控镇痛（PCIA）的效果。方法选择择期全麻下开胸肺叶切除手术患者60例,年龄18-65岁、体重40-100 kg、BMI 18-25 kg/m^2、性别不限、ASA分级Ⅰ-Ⅲ级,随机分为两组（各30例）：盐酸羟考酮注射液组（Q组）和枸橼酸舒芬太尼注射液组（S组）。两组均于手术结束前1 h开启静脉镇痛泵（麻醉药液均由生理盐水配制成100 ml,其中Q组含羟考酮0.8 mg/kg、昂丹司琼12 mg,S组含舒芬太尼2μg/kg、昂丹司琼12 mg）,机械泵行PCIA 48 h,输注速率2 ml/h,锁定时间15 min,自控按压0.5 ml/次。观察指标：术后6、24、48 h时行VAS评分、Ramsay评分,并记录术后48 h内补救镇痛药物使用情况、PCIA无效按压次数、恶心呕吐情况和镇痛满意度情况。结果 Q组患者术后6、24 h VAS评分均高于S组;Q组患者恶心呕吐发生率为16.7%（5例）,低于S组（30.0%,9例）;两组Ramsay评分、术后48 h VAS评分和镇痛满意度评分无统计学差异。结论 盐酸羟考酮（0.8 mg/kg）用于开胸肺叶切除PCIA时,镇痛效果弱于舒芬太尼（2μg/kg）,但恶心呕吐发生率低,两种药物的镇静程度与患者满意度无明显差异。Objective To compare the effects of oxycodone hydrochloride injection and sufentanil citrate injection for patient controlled intravenous analgesia in patients who suffered a pulmonary lobectomy. Methods A total of 60 cases（aged 18-65 years, weighing 40-100 kg, BMI 18-25kg/m^2, ASA Ⅰ-Ⅲ patients of both sexes） suffered a pulmonary lobectomy were randomly divided into 2groups, Q and S（n=30 each）： Group Q（oxycodone hydrochloride injection） and Group S（sufentanil citrate injection）. Both the two anaesthetics were diluted to 100 ml with physiological saline, in that group Q contained oxycodone 0.8 mg/kg, ondansetron 12 mg, group S contained sufentanil 2 μg/kg, ondansetron 12 mg. The two groups used analgesia infusion pump one hour before the end of surgery. The two groups continued to be infused anaesthetics for 48 h with mechanical pump; the infusion rate was 2 ml/h; lockout time was 15 minutes; the dose of controlled pressing was 0.5 ml/time. We evaluated VAS score and Ramsay score at 6 th, 24 th, 48 th hours after operation and recorded the times of using remedial analgesic within 48 hours, the times of pressing PCIA, the condition of post-operative nausea and vomiting（PONV）,the condition of patients satisfaction. Results The VAS scores of group Q were higher than group S at 6 h and 24 h after operation; The incidence of PONV in group Q was 16.7%, lower than group S（30.0%）;There was no significant difference in Ramsay scores, VAS scores and the patients satisfaction at 48 th hours after operation. Conclusion The analgesic effect of oxycodone hydrochloride（0.8 mg/kg） is weaker than sufentanil（2 μg/kg） for patient controlled intravenous analgesia in patients who suffered a pulmonary lobectomy, but the incidence of PONV is lower; there was no significant difference in the situation of sedation and patients satisfaction.

关 键 词：羟可酮 舒芬太尼 镇痛 病人控制 疼痛 手术后 

分 类 号：R614[医药卫生—麻醉学]