羟考酮注射液滴定法在急诊创伤后疼痛处理的临床观察  

Clinical application of oxycodone hydrochloride injection with titration to analgesia after emergency treatment of post-traumatic preoperative pain management

作　　者：缪小勇[1] 徐葭[1] 曹建平[1] 

机构地区：[1]解放军第四五五医院麻醉科,上海200052

出　　处：《临床军医杂志》2015年第11期1154-1156,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨羟考酮注射液滴定法在急诊创伤后术前疼痛处理的安全性和有效性。方法选择自2013年4月至2014年6月在我院急诊科就诊的创伤后急性剧烈疼痛（VAS〉80）患者120例,采用羟考酮注射液滴定法对患者的疼痛进行处理,观察并记录患者给药后5、10、15、20 min各时间点的收缩压（SBP）、舒张压（DBP）、心率（HR）、呼吸频率（RR）、脉搏氧饱和度（SpO2）;评判并记录给药后5、10、15、20 min各时间点的静态、动态VAS值,Ramesay镇静评分;记录患者恶心、呕吐、呼吸抑制、尿潴留等不良反应发生率;计算患者羟考酮的总用量。结果与给药前比较,给药后各时间点的SBP、DBP、HR有明显下降,差异有统计学意义（P〈0.05）;RR、SpO2值也有下降,但差异无统计学差异（P〉0.05）;给药后各项呼吸循环观察指标均在正常范围之内。给药后各时间点的静态、动态VAS疼痛评分均有明显下降,差异有统计学意义（P〈0.05）;给药后10、15 min两个时间点患者的静态疼痛达到缓解标准;镇静评分有明显差异,差异有统计学意义（P〈0.05）;发生恶心6（5.0%）例,呕吐患者3（2.5%）例,呼吸抑制患者2例（1.7%）,尿潴留患者4（3.3%）例,羟考酮的总用量0.08~0.10 mg/kg。结论羟考酮滴定法用于急诊创伤后术前疼痛处理是安全有效的,并以0.08~0.10 mg/kg的总用量为安全有效剂量。Objective To investigate the efficacy and safety of oxycodone hydrochloride injection with titration to analgesic after emer-gency treatment of post-traumatic preoperative pain management. Methods Totally 120 cases of post-traumatic acute severe pain （VAS〉80）,titration of oxycodone injection to deal with the pain of patients. SBP,DBP,HR,RR,SpO2 of the patient with medication after 5,10,15,20 minutes were observed and recorded. The VAS values,ramesay sedation scores after 5,10,15,20 minutes were eval-uated and recorded. The rate of adverse reaction happened cases of patients with nausea,vomiting,respiratory depression,urinary reten-tion were Recorded. Total consumption of patients with oxycodone was calculated. Results SBP,DBP,HR had declined obviously of all time points after the treatment of,the difference was statistically significant （P〈0. 05）. RR,SpO2 value had decreased,but there was no statistically difference （P〉0. 05）. Delivery after the observation indexes were within the normal range. VAS pain score of stat-ic,dynamic to different time points after the treatment were significantly lower,the difference was statistically significant （P〈0. 05）. The two nodes static to pain relief of 10,15 min after the treatment in patients was with standard. Sedation scores had obvious differ-ence,the difference was statistically significant （P〈0. 05）. Nausea was 6 （5. 0%） cases,vomiting was 3 （2. 5%） case,respiratory depression patients was 2 cases （ 1. 7%） , urinary retention was 4 （ 3. 3%） case. The total dosage of oxycodone were 0. 08 ~0. 1 mg/kg. Conclusion Titration method of oxycodone hydrochloride injection for analgesia after emergency treatment of post-trau-matic preoperative pain management is safe and effective,and the amount of 0. 08~0. 1 mg/kg is safe and effective.

关 键 词：羟考酮注射液 滴定法 急诊创伤 VAS疼痛评分 

分 类 号：R459.7[医药卫生—急诊医学]