盐酸羟考酮注射液用于腹腔镜胃癌根治术后自控静脉镇痛的临床效果  

Effects of oxycodone hydrochloride on the postoperative patient-controlled intravenous analgesiain gastric cancer patients undergoing laparoscopic radicalgastrectomy

作　　者：曹娟[1] 庞志路[1] Cao Juan;Pang Zhilu(Department of Anesthesiology, Henan Provincial People＇s Hospital, Zhengzhou 450003, Chin)

机构地区：[1]河南省人民医院麻醉科,郑州450003

出　　处：《中国实用医刊》2018年第6期40-42,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨盐酸羟考酮注射液用于腹腔镜胃癌根治术患者术后自控静脉镇痛（PCIA）的临床效果。 方法选择择期气管插管全麻下行腹腔镜胃癌根治术患者50例，ASA分级Ⅰ或Ⅱ级，年龄30～60岁，体质量50～75 kg，采用随机数字表法，将其分成两组：舒芬太尼组（A组），羟考酮组（B组），每组25例，手术结束前30 min，A组缓慢静脉注射舒芬太尼0.1 μg/kg、B组缓慢静脉注射盐酸羟考酮0.1 mg/kg。两组患者进入麻醉恢复室（PACU）后行PCIA，A组镇痛泵药物配方：舒芬太尼3 μg/kg＋氯化钠注射液100 ml；B组镇痛泵药物配方：盐酸羟考酮0.5 mg/kg＋氯化钠注射液100 ml，参数设置：输注速率2 ml/h,单次剂量2 ml，锁定时间15 min。分别在术后3、6、12、24、48 h，采用视觉模拟评分（VAS）评估患者活动时、静息时的疼痛程度及内脏痛情况，记录患者苏醒期及术后48 h内患者恶心、呕吐及嗜睡等发生情况。 结果 与A组比较，B组自主呼吸恢复时间、拔管时间及定向力恢复时间明显缩短（P〈0.05）；术后3～48 h，两组患者活动时、静息时的疼痛程度VAS评分比较，差异未见统计学意义（P〉0.05）；内脏痛VAS评分比较，B组较A组显著降低（P〈0.05）；与A组比较，B组苏醒期及术后48 h内患者恶心、呕吐及嗜睡发生率显著降低（P〈0.05）。 结论盐酸羟考酮用于腹腔镜胃癌根治术患者术后自控静脉镇痛能有效缓解术后疼痛，且对于内脏痛的镇痛效果优于舒芬太尼，同时不良反应发生率低于舒芬太尼。ObjectiveTo investigate the effects of oxycodone hydrochloride on the postoperative patient-controlled intravenous analgesia （PCIA） in gastric cancer patients undergoing laparoscopic radical gastrectomy. MethodsFifty gastric cancer patients were enrolled and randomly divided into the two groups： group A （sufentanil group） and group B （oxycodone group）, with 25 cases in each group. The included patients had ASA physical status I or II, and aged from 30 to 60 years old, weight ranged from 50 to 75 kg. All patients underwent general intraveneous anesthesia. Thirty minutes before the end of surgery, each patient in group A was injected intravenously with sufentanil 0.1 μg/kg, while oxycodone hydrochloride 0.1 mg/kg in group B. Both groups began to receive PCIA in PACU： group A： sufentanil 3 μg/kg＋ normal saline 100 ml, group B： oxycodone hydrochloride 0.5 mg/kg＋ saline 100 ml; parameter settings： the infusion rate of 2 ml/h, a single dose of 2 ml, lock time 15 minutes. And visual analogue scale （VAS） was performed to evaluate the dynamic pain, rest pain and visceral pain at 3, 6, 12, 24, and 48 h after operation. Meanwhile the incidences of nausea, vomiting and drowsiness were recorded in the recovery period and 48 h after operation. ResultsThe spontaneous breathing recovery time, extubation time and recovery time was significantly shorter in group B than those in group A （P〈0.05）. There was no significant difference in the VAS scores of dynamic pain, rest pain between the two groups（P〉0.05）. The VAS scores of visceral pain in group B was significantly lower than that of group A （P〈0.05）. The incidences of postoperative nausea and vomiting and lethargy of group B were significantly lower than those of group A（P〈0.05） in recovery period and 48 h after operation. ConclusionsOxycodone hydrochloride in laparoscopic radical gastrectomy for gastric cancer patients can effectively relieve the postoperative pain, and especially have better analgesic effect on viscera

关 键 词：羟考酮 舒芬太尼 自控静脉镇痛 术后疼痛 腹腔镜手术 胃癌 

分 类 号：R614[医药卫生—麻醉学]