羟考酮对鼻内镜手术患者麻醉苏醒期术后镇痛效果的影响  

Analgesic effect of oxycodone during post-anesthesia recovery in patients undergoing functional endoscopic sinus surgery

作　　者：何喜欢 翁浩[1] 刘海健[1] 

机构地区：[1]上海交通大学附属第六人民医院南院(上海市奉贤区中心医院)麻醉科,上海201499

出　　处：《中华全科医学》2017年第7期1120-1122,1149,共4页Chinese Journal of General Practice

基　　金：上海市卫生与计划生育委员会科研项目(201440-571)

摘　　要：目的评价不同剂量羟考酮对功能性内窥镜鼻窦外科手术(functional endoscopic sinus surgery,FESS)患者麻醉苏醒期术后镇痛效果的影响。方法选择年龄18~60岁,体重55~85 kg FESS患者90例,随机分为3组(n=30):A组(羟考酮0.1 mg/kg),B组(羟考酮0.15 mg/kg),C组(羟考酮0.2 mg/kg)。在手术结束前30 min给予羟考酮。记录手术结束时(T_1)、气管导管拔除时(T_2)、气管导管拔除后10 min(T_3)、出麻醉恢复室时(T_4)时HR、SBP、DBP、SPO_2。同时记录患者自主呼吸出现时间、气管导管拔除时间、拔管时SAS评分、导管拔除后20min时Ramsay评分和VAS评分、拔管期间满意度评分和恶心、呕吐例数。结果 C组患者恶心(12例)及呕吐(12例)例数比其他2组多(P<0.05);T_2时3组间HR、DBP比较差异有统计学意义(P<0.05);T_3时A组HR、SBP和DBP及T_4时A组HR、SBP和DBP均高于其他2组(P<0.05);而T3时C组SPO_2低于其他2组(P<0.05);3组间SAS评分差异有统计学意义(P<0.05);A组拔管满意度评分及VAS评分高于其他2组(P<0.05),而Ramsay评分低于其他2组,差异有统计学意义(P<0.05)。结论给予羟考酮0.15 mg/kg可以使FESS患者麻醉苏醒效果最佳。Objective To evaluate the analgesic effect of different dose of oxycodone during post-anesthesia recovery in the patients undergoing functional endoscopic sinus surgery （FESS）. Methods Total 90 patients planned to receive FESS, aged 18- 60 years ,weighing 55 -85 kg, ASA status Ⅰ or Ⅱ , were randomized and assigned into group A, group B and group C （ n = 30）. The patients in group A, B and C received oxycodone of 0.1,0.15 ,0. 2 mg/kg,respectively. Oxycodone was given at 30 rain before the termination of FESS. HR, SBP, DBP and SPO2 were recorded at the surgery closure （ T1 ） , extubation（T2） , 10 min after extubation （ T3 ） and departure from PACU （ T4 ） ; Time to spontaneous breathing and extubation, SAS during extubation, Ramsay and VAS 20 min after extubation termination, satisfaction score of extubation, and the cases of nausea and vomiting were also recorded. Results The cases of nausea （ 12 cases） and vomiting （ 12 cases） in group C were the most among the three groups（P 〈 0.05） ;HR, SBP and DBP were significantly different among the three groups at T2 （ P 〈 0.05 ） ; HR, SBP and DBP at T3 in group A, and HR, SBP and DBP at T4 were the highest in the three groups;SPO2 at T3 in group C was the lowest（P 〈0.05） ;The SAS was significant differences among the three groups（P 〈 0.05） ;In group A,extubation satisfaction score and VAS were the highest,while the Ramsay was the lowest among the three groups （ P 〈 0.05 ）. Conclusion The 0.15 mg/kg of Oxycodone is the ideal dose for post-anesthesia recovery of patients undergoing functional endoscopic sinus surgery.

关 键 词：羟考酮 功能性内窥镜鼻窦外科手术 麻醉后复苏 

分 类 号：R614.2[医药卫生—麻醉学] R765.9[医药卫生—外科学]