分时段递减羟考酮镇痛方案用于腹部手术术后镇痛的有效性和安全性  

Efficacy and safety of phased-down oxycodone analgesia regimen for postoperative analgesia after abdominal surgery

作　　者：张云霄[1] 谭宏宇[1] 董长江[1] 范志毅[1] ZHANG Yun-xiao;TAN Hong-yu;DONG Chang-jiang;FAN Zhi-yi(Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing),Department of Anesthesiology,Peking University Cancer Hospital&Institute,Beijing 100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所麻醉科恶性肿瘤发病机制及转化研究教育部重点实验室

出　　处：《中国新药杂志》2019年第23期2852-2856,共5页Chinese Journal of New Drugs

摘　　要：目的:探索分时段递减羟考酮镇痛方案用于腹部手术术后镇痛的有效性和安全性。方法:采用随机、双盲、平行对照研究,入组患者60例:对照组31例;试验组29例。两组均行静吸复合麻醉,术后接受静脉自控镇痛(patient-controlled intravenous analgesia,PCIA)。对照组:PCIA背景输注速率持续不变,设定为1 mL·h-1;试验组:PCIA背景输注速率分时段递减,于术后0~4,4~12,12~48 h分别设定为3,2,1 mL·h-1。两组患者PCIA药液配方及其他参数设定均一致。主要研究终点:术后4,12,24和48 h动、静态视觉模拟疼痛评分(visual analogue scale,VAS);次要研究终点:镇痛泵按压次数及用药量;患者镇痛满意度;患者术后恶心、呕吐及镇痛相关不良事件的发生率。结果:与对照组相比,试验组患者术后4和12 h动、静态及术后24 h动态VAS评分显著降低(P<0.05);镇痛泵有效按压次数及无效/总按压次数显著降低(P<0.05);患者术后镇痛满意度显著升高(P<0.05)。两组患者镇痛泵总用药量及术后恶心呕吐和其他不良事件发生率无统计学差异。结论:分时段递减羟考酮镇痛方案可有效缓解腹部手术患者术后疼痛,提高患者镇痛满意度,且不增加术后镇痛药用量及不良事件发生率。Objective:To evaluate the efficacy and safety of phased-down oxycodone analgesia regimen for postoperative analgesia in patients undergoing abdominal surgery.Methods:Sixty patients were enrolled in the randomized,double blind,parallel controlled study and were randomly divided into 2 groups:control group(n=31)and test group(n=29).Both groups received general anesthesia and were given patient-controlled intravenous analgesia(PCIA)after surgery.The background infusion rate was set at 1 mL·h-1 in control group while in test group phased-down was used setting at 3,2,1 mL·h-1 at 0~4,4~12,12~48 h after surgery.All the other parameters of PCIA were the same between the 2 groups.Primary endpoints:dynamic and static visual analogue scale(VAS)score at 4,12,24 and 48 h after surgery;secondary endpoints:times of pressing and dosage of nacotics consumption in PCIA;patient’s satisfaction score;incidence of postoperative nausea,vomiting and adverse events related to analgesia.Results:Compared with control group,the dynamic and static VAS score at 4 h and the dynamic VAS at 12 h after surgery significant reduced in test group(P<0.05).The times of effective pressing and the ratio of ineffective/total times of pressing significantly decreased in test group(P<0.05).Also,the level of patient’s satisfaction increased in group B(P<0.05).There were no significant differences in the total narcotics consumption as well as the incidence of postoperative nausea,vomiting and adverse events between the two groups.Conclusion:The phased-down oxycodone analgesia regimen can effectively relieve the postoperative pain in patients undergoing abdominal surgery,increase patients’satisfaction and do not increase total narcotics consumption and the incidence of adverse events.

关 键 词：羟考酮 分时段递减 术后镇痛 患者控制 腹部手术 

分 类 号：R971.2[医药卫生—药品] R969.4[医药卫生—药学]