羟考酮与左旋布比卡因治疗外周动脉阻塞性疾病疼痛的效果对比  

Pain management in peripheral arterial obstructive disease: oral slow-release oxycodone versus epidural L-bupivacaine

作　　者：崔瞻 张宏江 于晖[2] 

机构地区：[1]珠海市第二人民医院麻醉科,广东珠海519520 [2]北京医院国家老年医学中心麻醉科,北京100073

出　　处：《临床药物治疗杂志》2017年第11期74-76,共3页Clinical Medication Journal

摘　　要：目的:比较羟考酮与左旋布比卡因治疗外周动脉阻塞性疾病(PAOD)患者中度/重度疼痛的效果。方法:40例PAOD患者随机分为羟考酮组(OX组)和左旋布比卡因组(LRA组)。两组患者均在术后7 d或未手术出院前进行疼痛治疗,OX组口服缓释羟考酮10~20 mg,bid;LRA组每6 h硬膜外注射4 mL 0.25%左布比卡因。采用静息(VASs)和运动(VASd)视觉模拟评分测定镇痛效果;记录生命体征、治疗的不良反应及患者满意度。结果:两组疼痛控制满意,VAS评分中位数分别是VASs<3和VASd<4;但是动态情况下,LRA组疼痛控制较OX组更好(P<0.05)。除了少数和短暂的不良反应,大多数患者(n=38)对疼痛治疗满意度是好或优秀。结论:硬膜外给予左旋布比卡能有效控制PAOD患者的疼痛;对于硬膜外禁忌或未行手术和门诊的患者,口服缓释羟考酮可作为替代治疗方法。Objective： To compare the effectiveness of oxycodone with that of L-bupivacaine（group LRA） for the control of moderate/severe pain of patients with advanced-stage peripheral arterial obstructive disease（PAOD）. Methods： Forty hospitalized PAOD patients treated for pain management for at least 7 days after surgery or discharged from the hospital without surgery were random Ly divided into oral slow-release oxycodone group（group OX） and epidural L-bupivacaine group（group LRA）. The outcome measures were pain intensity using the visual analogue scale under static,（VASs） and dynamic（VASd） conditions, vital signs, treatment side effects and patient satisfaction. Results： In both groups, pain control was satisfactory and VAS scores median were VASs 3 and VASd 4; under dynamic conditions, pain control was better in the LRA group（P0.01）. Against few and transient side effects, most patients（n =38） found both pain treatments good or excellent. Conclusion： In the perioperative settings, epidural infusion of local anaesthetics, such as L-bupivacaine, is an effective technique for pain control in PAOD patients; for patients with contraindications for this technique or for nonsurgical or outpatients, slow-release oxycodone is suggested as a possible alternative for the control of severe pain.

关 键 词：疼痛治疗 外周动脉阻塞性疾病 硬膜外 阿片类药物 羟考酮 

分 类 号：R969.3[医药卫生—药理学]