羟考酮用于宫腔镜检查术的临床观察  

Observation of oxycodone for hysteroscopy

作　　者：谢宇飞[1] 宋丹丹[1] 曹雨 许兆柱[1] 

机构地区：[1]沈阳军区总医院麻醉科,沈阳110016

出　　处：《实用药物与临床》2017年第11期1269-1271,共3页Practical Pharmacy and Clinical Remedies

摘　　要：目的观察盐酸羟考酮注射液用于宫腔镜检查术的临床有效性及安全性。方法择期行宫腔镜检查术的患者80例,ASAⅠ~Ⅱ级,随机分为2组,芬太尼组(F组)和羟考酮组(Q组)。F组全麻诱导采用芬太尼1μg/kg,Q组采用羟考酮0.1 mg/kg,随后给予丙泊酚2~2.5 mg/kg,术中以丙泊酚4~8 mg/(kg·h)、右美托咪定0.8μg/(kg·h)维持麻醉,记录并比较诱导前(T_0)、诱导后(T_1)、扩宫颈(T_2)、宫腔内操作(T_3)、苏醒即刻(T_4)的MAP、HR及SpO_2,记录并比较术中呼吸抑制发生率及术后恶心呕吐发生率,记录并比较两组患者苏醒后1 min、术后0.5 h、术后2 h视觉模拟评分(VAS)。结果两组患者诱导后均出现血压降低、心率减慢,但组间比较差异无统计学意义(P>0.05);在扩宫颈和宫腔内操作时,Q组的血流动力学改变更平稳。Q组术后宫缩痛镇痛VAS评分优于F组(P<0.05)。F组呼吸抑制发生率明显高于Q组(P<0.05)。结论芬太尼和羟考酮均能安全有效地用于宫腔镜检查术,羟考酮血流动力学更平稳,镇痛作用更强且呼吸抑制发生率低。Objective To observe the efficacy and safety of oxycodone for hysteroscopy. Methods Eighty patients（ ASAⅠ ~ Ⅱ） undergoing elective hysteroscopy were randomly divided into two groups： fentanyl group（ group F） and oxycodone group（ group Q）. Fentanyl 1 μg/kg ＋ propofol 2 ~ 2. 5 mg/kg were used in group F,and oxycodone 0. 1 mg/kg ＋ propofol 2 ~ 2. 5 mg/kg in group Q,and then propofol 4 ~ 8 mg/（ kg·h） and dexmedetomidine 0. 8μg/（ kg·h） were used to maintain the anesthesia during the operation. MAP,HR and SpO_2 were recorded before induction（ T_0）,after induction（ T_1）,during dilating cervix uteri（ T_2） and operating in uterine cavity（ T_3） and after recovery（ T_4）. The incidences of postoperative respiratory depression and postoperative nausea and vomiting were recorded and compared,and the visual analogue score（ VAS） was recorded and compared between the two groups at 1 min after recovery and 0. 5 h and 2 h after operation. Results The blood pressure and heart rate were decreased in the two groups after induction,but there was no significant difference between the two groups（ P〈0. 05）. The hemodynamic changes in group Q were more stable at T_2 and T_3,and the VAS score of group Q was significantly less than that of group F（ P〈0. 05）. The incidence of respiratory depression was significantly higher in group F than that of group Q（ P〉0. 05）. Conclusion Fentanyl and oxycodone are safe and effective for hysteroscopy,and oxycodone has more stable hemodynamics,stronger analgesic effect and lower incidence of respiratory depression.

关 键 词：羟考酮 芬太尼 宫腔镜检查术 不良反应 

分 类 号：R614[医药卫生—麻醉学]