羟考酮与舒芬太尼用于胸腔镜肺癌根治术后病人静脉镇痛效果的比较  

Efficacy of oxycodone versus sufentanil for intravenous analgesia after radical resection of pulmonary carcinoma performed via video-assisted thoracoscope

作　　者：张云霄[1] 陈冀衡[1] 范志毅[1] 刘英华[1] 姚月勤[1] 孔国华[1] 

机构地区：[1]恶性肿瘤发病机制及转化研究教育部重点实验室,北京大学肿瘤医院暨北京市肿瘤防治研究所麻醉科,100142

出　　处：《中华麻醉学杂志》2015年第10期1228-1230,共3页Chinese Journal of Anesthesiology

摘　　要：目的 比较羟考酮与舒芬太尼用于胸腔镜肺癌根治术后病人静脉镇痛的效果.方法 择期行胸腔镜肺癌根治术病人154例,年龄18 ～ 64岁,性别不限,BMI 18～25 kg/m2,ASA分级Ⅰ或Ⅱ级.采用随机数字表法,将其分为2组：舒芬太尼组（S组,n=76）和羟考酮组（O组,n=78）.2组均接受静吸复合麻醉.术后当VAS评分≥4分时,2组分别静脉注射舒芬太尼5μg或羟考酮2 mg,必要时重复给药,直至VAS评分≤3分,随后进行PCIA,镇痛至术后48 h,S组PCIA泵药液配方为托烷司琼20 mg＋舒芬太尼200 μg,用生理盐水稀释至100 ml;0组PCIA泵药液配方为托烷司琼20mg＋羟考酮50 mg,用生理盐水稀释至100 ml,背景输注速率1 ml/h,PCA剂量2 ml,锁定时间10 min,维持VAS评分≤3分,当VAS评分≥4分时肌肉注射吗啡10 mg补救镇痛.记录补救镇痛情况、病人镇痛满意度及镇痛有关不良事件的发生情况.结果 与S组比较,O组恶心和呕吐的发生率降低（P＜0.05）,术后补救镇痛率、病人镇痛满意度、头晕和镇静过度的发生率差异无统计学意义（P＞0.05）.2组未见呼吸抑制和皮肤瘙痒发生.结论 与舒芬太尼比较,羟考酮用于胸腔镜肺癌根治术后病人静脉镇痛时可达到相似的镇痛效果,且恶心和呕吐发生率较低.Objective To compare the efficacy of oxycodone versus sufentanil for intravenous analgesia after radical resection of pulmonary carcinoma performed via video-assisted thoracoscope.Methods One hundred fifty-four patients of both sexes, aged 18-64 yr, with body mass index of 18-25 kg/m2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective radical resection of pulmonary carcinoma performed via video-assisted thoracoscope, were randomly divided into either sufentanil group （group S, n=76） or oxycodone group （group O, n =78） using a random number table.The 2 groups received combined intravenous-inhalational anesthesia.When postoperative visual analogue scale （VAS） score ≥ 4, sufentanil 5 μg or oxycodone 2 mg was injected intravenously, and the administration was repeated when necessary until VAS score ≤ 3.Patient-controlled intravenous analgesia （PCIA） was then used for postoperative analgesia （lasting for 48 h）.PCIA solution contained tropisetron 20 mg and sufentanil 200 μg in 100 ml of normal saline in group S.PCIA solution contained tropisetron 20 mg and oxycodone 50 mg in 100 ml of normal saline in group O.The PCIA pump was set up to deliver a 2 ml bolus dose with a 10 min lockout interval and background infusion at a rate of 1 ml/h.VAS score was maintained ≤3.When VAS scores ≥4, morphine 10 mg injected intramuscularly was used as rescue analgesic.The requirement for rescue analgesic, level of patient＇s satisfaction with analgesia,and analgesia-related adverse events were recorded.Results The incidence of nausea and vomiting was significantly lower in group O than in group S （P〈0.05）.There was no significant difference in the requirement for rescue analgesic, level of patient＇s satisfaction, and incidence of dizziness and over-sedation between the two groups （P〉0.05）.No patients developed respiratory depression and pruritus in the two groups.Conclusion Compared with sufentanil, oxycodone can produce similar analgesic efficacy wh

关 键 词：羟可酮 舒芬太尼 疼痛 手术后 

分 类 号：R614[医药卫生—麻醉学] R734.2[医药卫生—外科学]