氢吗啡酮与羟考酮在胸腔镜肺癌根治术后患者自控静脉镇痛临床疗效  

Clinical effect of hydromorphone and oxycodone in patient-controlled intravenous analgesia after thoracoscopic radical resection of lung cancer

作　　者：魏顺民 孙绪德 WEI Shunmin;SUN Xude(Department of Anesthesiology,Tangdu hospital,Air Force Medical University,Xi′an 710038,China)

机构地区：[1]空军军医大学唐都医院麻醉科,西安710038

出　　处：《实用医学杂志》2021年第22期2908-2913,共6页The Journal of Practical Medicine

摘　　要：目的研究氢吗啡酮与羟考酮在胸腔镜肺癌术后患者自控静脉镇痛(PCIA)镇痛效果。方法选取拟行肺癌根治术患者144例,分为3组,氢吗啡酮组60例,羟考酮组39例,舒芬太尼组45例,行PCIA,记录术后3、6、12、24、36、48 h数字疼痛评分(NRS)及不良反应。结果 3组药物NRS评分差异有统计学意义(P<0.05),多重比较显示氢吗啡酮和羟考酮分别与舒芬太尼镇痛效果差异有统计学意义(P<0.05);氢吗啡酮与羟考酮镇痛效果差异无统计学意义(P>0.05)。术后3、6、24、36、48 h各不良反应发生差异无统计学意义(P>0.05);术后12 h,头晕不良反应发生率组间差异有统计学意义(P<0.05)。多重比较显示氢吗啡酮与舒芬太尼在术后12 h头晕发生率差异有统计学意义(P=0.010<0.0125)。结论氢吗啡酮PCIA结合椎旁阻滞及静注酮咯酸氨丁三醇的多模式镇痛,可提供肺癌术后舒适医疗。Objective To study the analgesic effect of hydromorphone and oxycodone on PCIA after thoracoscopic lung cancer surgery. Methods 144 patients with lung cancer were divided into three groups. 60 cases wereincluded in hydromorphone group,while 39 cases and 45 caseswererespectivelyincluded in oxycodone group and sufentanil group. PCIA was performed. NRS and adverse reactions at 3,6,12,24,36 and 48 hours were recorded. Results There was significant difference in NRS score among the three groups(P < 0.05). Multiple comparisons:the analgesic effects of hydromorphone and oxycodone were statistically significant from sufentanil(P < 0.05),whilethere was no significant difference between hydromorphone and oxycodone(P > 0.05). Adverse reactions:there was no significant difference at 3,6,24,36 and 48 hours(P > 0.05);whilethere was significant difference in dizziness 12 hours after operation(P < 0.05). Inmultiple comparisons,the incidence of dizziness between HM and SF was statistically significant(P = 0.010 < 0.0125,Chi-square partition). Conclusion The multimodal analgesia of hydromorphone PCIA combined with TPVB and intravenous ketorolac tromethamine can provide comfortable treatment after lung cancer surgery.

关 键 词：氢吗啡酮 羟考酮 术后镇痛 肺癌 

分 类 号：R614[医药卫生—麻醉学] R969[医药卫生—外科学]