羟考酮预防结直肠癌手术患者全麻后寒战  

Oxycodone prevented postoperative shivering after general anesthesia in patients undergoing colorectal cancer surgery

作　　者：杜学柯[1] 潘灵辉[1] 葛万运[1] 周成茂 

机构地区：[1]广西医科大学附属肿瘤医院,广西南宁530021

出　　处：《中国新药与临床杂志》2016年第4期294-298,共5页Chinese Journal of New Drugs and Clinical Remedies

基　　金：广西自然基金青年基金项目(2013GXNSFBA019182)

摘　　要：目的观察羟考酮对结直肠癌手术患者全麻后寒战的预防作用。方法拟全麻下行结直肠癌手术的患者120例,随机分为羟考酮组和对照组,每组60例。两组麻醉诱导和维持方法相同。羟考酮组在手术结束前30 min静脉给予羟考酮注射液0.08 mg·kg^(-1),对照组给予等体积的氯化钠注射液。监测心率(HR)、平均动脉压(MAP)、血氧饱和度和鼻咽温度,记录麻醉前(T_0)、手术开始时(T_1)、手术结束时(T_2)、拔管时(T_3)、拔管后30 min(T_4)和60 min(T_5)患者的HR和MAP值。观察并记录T_3、T_4和T_5时的视觉模拟量表(VAS)评分和Ramsay镇静评分,记录拔管后1 h内寒战分级及不良反应发生的情况。结果最终完成114例,羟考酮组58例,对照组56例。与T0时比较,对照组患者T_3、T_4和T_5时间点HR明显增快(P<0.05),MAP增高(P<0.05),而羟考酮组HR和MAP无明显变化。对照组寒战发生率为36%(21/58),明显高于羟考酮组(14%,8/56,P<0.05)。T_3、T_4和T_5时间点羟考酮组患者的Ramsay镇静评分高于对照组,VAS评分低于对照组(均P<0.05)。两组均无严重不良反应发生,恶心、呕吐发生率组间无显著差异(P>0.05)。结论手术结束前30 min给予羟考酮0.08 mg·kg^(-1)可有效预防结直肠癌手术患者全麻后寒战的发生。AIM To observe the effects of oxycodone on preventing shivering after general anesthesia in patients undergoing colorectal cancer surgery. METHODS One hundred and twenty patients scheduled for colorectal cancer surgery were assigned randomly into oxycodone group and control group（n = 60）. All patients received the same anesthesia induction and maintenance. The patients in the oxycodone group received oxycodone 0.08 mg·kg^（-1） 30 min before the end of surgery, while the patients received the sodium chloride injection in the control group. Heart rate（HR）, mean arterial pressure（MAP）, oxygen saturation and nasopharyngeal temperature were continually monitored. HR and MAP were recorded before anesthesia（T_0）, at the beginning of operating（ T_1）, the end of operating（T_2）, the time of extubation（T_3）, 30 min after extubation（ T_4） and 60 min after extubation（ T_5）. Pain evaluation was assessed by visual analogue scale（ VAS） and sedation was evaluated by Rassay sedation scale as well at T_3, T_4 and T_5. The grades of shivering and adverse reactions were recorded in one hour after extubation. RESULTS There were 114 patients completing the trial, 58 patients in the oxycodone group and 56 patients in the control group. Compared with those at T_0, HR and MAP increased at T_3, T_4, T_5 in the control group（P 〈0.05）. While there were no obvious changes in the oxycodone group.The shivering rate in the oxycodone group was lower than that in the control group（14%（8/56） vs. 36%（21/58）, P〈0.05）. Compared with those in the control group, VAS scores were lower at T_3, T_4, T_5 in the oxycodone group（P 〈0.05）, and the Ramsay sedation scale scores were higher（P 〈0.05）. No serious adverse reaction occurred in both groups. There was no obvious difference in incidence of nausea and vomiting between two groups（P 〉0.05）. CONCLUSION Infusion of oxycodone 0.08 mg·kg^（-1） 30 min before the end of operation may be effective in preventing post-anesthetic s

关 键 词：羟考酮 寒战 结直肠肿瘤 手术后期间 

分 类 号：R971[医药卫生—药品]