羟考酮和舒芬太尼用于胸腔镜肺叶切除术后患者自控静脉镇痛的比较  

A Comparison of oxycodone and sufentanil for patient-controlled intravenous analgesia afterthoracoscopic lobectomy

作　　者：叶伟光[1] 王天龙[1] 张宁[2] 

机构地区：[1]首都医科大学宣武医院麻醉科,北京100053 [2]北京老年医院麻醉科

出　　处：《北京医学》2017年第6期562-565,共4页Beijing Medical Journal

基　　金：北京市医院管理局"登峰"人才培养计划(编号:DFL20150802)

摘　　要：目的比较羟考酮和舒芬太尼用于胸腔镜肺叶切除术术后患者自控静脉镇痛的效果和不良反应。方法选择美国麻醉医师协会(ASA)Ⅰ或Ⅱ择期行全麻下行胸腔镜肺叶切除术患者60例,随机分为两组,每组30例,羟考酮组和舒芬太尼组,两组患者均接受静脉自控镇痛48 h。在第1,4,8,16,24和48 h记录两组患者VAS评分和镇静评分,两组患者不良反应发生率和总体满意度。结果两组患者在术后各时间点镇痛和镇静评分差异无统计学意义(P>0.05),术后总体满意度比较差异无统计学意义(P>0.05),羟考酮累计使用剂量显著低于舒芬太尼组(P<0.05),羟考酮组尿潴留发生率低于舒芬太尼组(P<0.05)。结论羟考酮和舒芬太尼整体效果相当,总体使用剂量低,可作为胸腔镜肺叶切除术术后镇痛的选择。Objective The aim of this study was to access the efficacy and adverse effects of oxycodone and sufentanil in patient controlled analgesia （PCA） after thoracoscopic lobectomy. Methods A total of 60 patients（ASA I or II）un- dergoing thoracoscopic lobectomy were randomly assigned to receive either oxycodone or sufentanil using intravenous patient-controlled analgesia （PCA）. PCA was administered as a time-scheduled continuous infusion based on lean body mass for 48 hours postoperatively. Patients were assessed for pain with a visual analogue scale （VAS）, the cumulative PCA dose, adverse effects, sedation level at 1, 4, 8, 16, 24, and 48 hours postoperatively, and satisfaction during the postoperative 48 hours. Results There were no significant differences （P 〉 0.05） between the two groups in VAS score, sedation level at 1, 4, 8, 16, 24, and 48 hours postoperatively, and satisfaction at 48 hours postoperative. Cumulative PCA dose of oxycodone group at 48 h was significantly less than that of sufentanil group. The incidence of pruritus in the oxycodone group was less compared to the sufentanil group. Conclusion Oxycodone has shown comparable effects for pain relief compared to sufentanil in spite of less cumulative PCA dose. Based on these results, we could conclude that oxycodone may be useful as an alternative to sufentanil for PCA after thoracoscopic lobectomy.

关 键 词：舒芬太尼 羟考酮 患者自控镇痛 胸腔镜肺叶切除术 术后疼痛 

分 类 号：R614[医药卫生—麻醉学]