羟考酮超前镇痛在成人局部麻醉眼底手术中的效果  

The effect of preemptive analgesia with oxycodone in ophthalmic surgery under local anesthesia

作　　者：胡春华 王古岩 崔旭[1] 王惠军[1] 奚春花[1] HU Chun-hua;WANG Gu-yan;CUI Xu;WANG Hui-jun;XI Chun-hua(Department of Anesthesiology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院麻醉科,北京100730

出　　处：《临床药物治疗杂志》2020年第8期14-17,共4页Clinical Medication Journal

摘　　要：目的探讨羟考酮超前镇痛在成人局部麻醉眼底手术中的效果。方法100例成人局部麻醉眼底手术患者,随机数字表法分为对照组49例和试验组51例。对照组术前5 min应用咪达唑仑1 mg(加0.9%生理盐水至10 m L);试验组术前5 min应用咪达唑仑1 mg及羟考酮0.1 mg/kg(加0.9%生理盐水至10 m L)。记录患者静脉给药前(T0),静脉给药后5 min(T1),球后神经阻滞时(T2),手术开始5 min时(T3),手术后30 min(T4)及术毕(T5)的平均动脉压(MAP)、心率(HR)、脉搏、血氧饱和度(Sp O2)、呼吸频率(RR)、脑电双频指数(BIS)和镇静评分(Ramsay镇静评分)。术毕采用视觉模拟评分法(VAS)评定患者疼痛程度及不良反应发生情况。结果T2、T3和T4,对照组患者的MAP、HR和BIS明显高于试验组[MAP:分别为(89.5±6.3)mm Hg vs.(80.5±4.8)mm Hg、(88.5±6.2)mm Hg vs.(78.5±3.6)mm Hg和(85.5±8.0)mm Hg vs.(76.9±3.9)mm Hg;HR:(95.5±6.1)次vs.(83.9±5.1)次、(93.3±7.1)次vs.(84.1±6.2)次和(92.2±4.7)次vs.(83.3±6.2)次;BIS:(80.6±4.9)vs.(67.5±5.1)、(78.5±3.2)vs.(66.5±6.0)和(88.5±4.2)vs.(72.1±4.8),均P<0.05];Ramsay镇静评分低于试验组[(1.6±0.4)分vs.(2.5±0.3)分、(1.6±0.3)分vs.(2.4±0.4)分和(1.5±0.4)分vs.(2.3±0.3)分,均P<0.05];VAS评分对照组明显高于试验组[(2.6±0.4)分vs.(1.1±0.3)分,P<0.05];2组患者均无恶心呕吐、呼吸抑制等不良反应发生。结论羟考酮超前镇痛安全有效,适用于成人局部麻醉眼底手术,值得临床推广。Objective To investigate the effect of oxycodone preemptive analgesia in adult patients with local anesthesia fundus surgery.Methods Totally 100 adult patients with local anesthesia fundus surgery were randomly divided into control group 49 cases with intravenous midazolam 1 mg(add 0.9%sodium chloride to 10 m L)5 min before operation;and experimental group 51 cases with intravenous midazolam 1 mg and oxycodone 0.1 mg/kg(add 0.9%sodium chloride to 10 m L)5min before operation.Before intravenous administration(T0),5 min after intravenous administration(T1),the moment of retrobulbar nerve blocked(T2),5 min after operation(T3),30 min after operation(T4),end of operation(T5),mean arterial pressure(MAP),heart rate(HR),pulse oxygen saturation(Sp O2),respiratory rate(RR),bispectral index(BIS),and sedation score(Ramsay score)were monitored and compared during operation.After the operation,Visual Analogue Scale(VAS)was used to assess the degree of pain and the adverse reactions were recorded.Results At the time of T2、T3and T4,the MAP,HR and BIS in the control group was significantly higher than that in experimental group[MAP:(89.5±6.3)mm Hg vs.(80.5±4.8)mm Hg,(88.5±6.2)mm Hg vs.(78.5±3.6)mm Hg,(85.5±8.0)mm Hg vs.(76.9±3.9)mm Hg;HR:(95.5±6.1)次vs.(83.9±5.1)次,(93.3±7.1)次vs.(84.1±6.2)次,(92.2±4.7)次vs.(83.3±6.2)次;BIS:(80.6±4.9)vs.(67.5±5.1),(78.5±3.2)vs.(66.5±6.0),(88.5±4.2)vs.(72.1±4.8);all P<0.05];Ramsay Sedation scores were significantly lower than those in experimental group[(1.6±0.4)分vs.(2.5±0.3)分,(1.6±0.3)分vs.(2.4±0.4)分,(1.5±0.4)分vs.(2.3±0.3)分;all P<0.05)];the VAS score of control group was significantly higher than that of experimental group[(2.6±0.4)分vs.(1.1±0.3)分,P<0.05)];there were no adverse reactions such as nausea,vomiting and respiratory depression in both groups.Conclusion Oxycodone preemptive analgesia is safe,effective,and suitable for adult local anesthesia fundus surgery,which is worthy of clinical promotion.

关 键 词：超前镇痛 局部麻醉 眼底手术 

分 类 号：R971.2[医药卫生—药品]