羟考酮单次静脉注射对腹腔镜胆囊切除术患者术后镇痛的影响  

Effect of Single Intravenous Injection of Oxycodone on Postoperative Analgesia in Patients with Laparoscopic Cholecystectomy

作　　者：庞志红[1] 金恒 张玉 郭宏志[1] PANG Zhi-hong;JIN Heng;ZHANG Yu;GUO Hong-zhi(Department of Hepatobiliary,Pancreatic and Spleen Surgery,Nanyang First People's Hospital,Nanyang 473000,China)

机构地区：[1]南阳市第一人民医院肝胆胰脾外科,南阳473000

出　　处：《中国合理用药探索》2021年第10期66-70,共5页Chinese Journal of Rational Drug Use

摘　　要：目的:研究羟考酮单次静脉注射对腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)患者术后镇痛的影响。方法:选择2017年2月~2020年4月在本院就诊的腹腔镜下胆囊切除术患者112例作为研究对象,采用随机数字表法分为观察组和对照组,每组56例。在行LC前15 min,观察组静脉注射盐酸羟考酮0.1 mg/kg,对照组静脉注射相同剂量生理盐水。观察两组患者术后2、6和12 h时的疼痛等级评定量表评分(visual analog scale,VAS)、Ramsay镇静量表评分(Ramsay sedation scale,RSS);观察麻醉前、拔管时、拔管5 min时收缩压(systolic blood pressure,SBP)、舒张压(diastole blood pressure,DBP)和心率变化;观察患者在术后3天出现肺部感染、腹胀、嗜睡、呼吸抑制的情况;观察麻醉前、拔管时、拔管5 min后血清中皮质醇(cortisol,COR)和去甲肾上腺素(norepinephrine,NE)水平变化。结果:观察组在术后2、6和12 h的VAS评分低于对照组(P<0.05),术后2、6和12 h的RSS评分高于对照组(P<0.05),拔管时、拔管5 min的SBP、DBP、心率低于对照组(P<0.05),术后肺部感染的发生率低于对照组(P<0.05),拔管时、拔管5 min的COR和NE低于对照组(P<0.05)。结论:羟考酮单次静脉注射可改善LC患者术后镇痛效果、减轻麻醉苏醒应激反应,减少肺部感染等不良反应的发生,效果较好。Objective:To study the effect of oxycodone patient-controlled intravenous analgesia on postoperative analgesia in patients undergoing laparoscopic cholecystectomy(LC).Methods:A total of 112 patients with laparoscopic cholecystectomy in our hospital from February 2017 to April 2020 were selected as the research subjects,and they were divided into observation group and control group by random number table method,with 56 patients in each group.15 min before LC,the observation group was intravenously injected with 0.1 mg/kg oxycodone hydrochloride,and the control group was given the same dose of normal saline intravenously.Visual analog scale(VAS)and Ramsay sedation scale(RSS)scores of the two groups were observed at 2,6 and 12 h after surgery.Systolic blood pressure(SBP),diastole blood pressure(DBP)and heart rate were observed before anesthesia,during extubation and 5 min after extubation.Pulmonary infection,abdominal distension,drowsiness and respiratory depression were observed 3 days after the operation.Serum cortisol(COR)and norepinephrine(NE)levels were observed before anesthesia,during extubation and 5 min after extubation.Results:VAS score at 2,6 and 12 h after operation in the observation group was significantly lower than that in the control group(P<0.05);and the RSS score at 2,6 and 12 h after operation in the observation group was significantly higher than that in the control group(P<0.05).The SBP,DBP and heart rate of 5 min during extubation and extubation were significantly lower than those in the control group(P<0.05);and the incidence of postoperative pulmonary infection in the observation group was significantly lower than that in the control group(P<0.05).COR and NE on extubation and after extubation 5 min were significantly lower than those in the control group(P<0.05).Conclusion:Single intravenous injection of oxycodone for LC patients can improve postoperative analgesia effect,relieve the stress response of anesthesia and recovery,reduce the occurrence of lung infection and other adverse reaction

关 键 词：羟考酮 腹腔镜胆囊切除术 镇痛 应激 肺部感染 

分 类 号：R971[医药卫生—药品]