羟考酮自控静脉镇痛联合腹横肌平面阻滞用于腹腔镜根治性肾切除术的镇痛效果  

Analgesic effect of oxycodone in patient controlled intravenous analgesia combined with transversus abdominis plane block for patient undergoing laparoscopic radical nephrectomy

作　　者：王晓娜 温晶 WANG Xiaona;WEN Jing(Department of Anesthesiology,the Second Hospital of Baoding,Hebei Baoding 071051,China)

机构地区：[1]保定市第二医院麻醉科,河北保定071051

出　　处：《现代肿瘤医学》2022年第24期4528-4531,共4页Journal of Modern Oncology

摘　　要：目的:观察羟考酮自控静脉镇痛联合腹横肌平面阻滞用于腹腔镜根治性肾切除术的镇痛效果。方法:选择60例美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级Ⅰ或Ⅱ级行腹腔镜根治性肾切除术的患者,性别不限,年龄18~76岁,随机分为2组:腹横肌平面阻滞联合羟考酮自控静脉镇痛组(TO组,n=30)和羟考酮自控静脉镇痛组(O组,n=30)。TO组行腹横肌平面阻滞,注射0.25%罗哌卡因20 mL。TO组和O组均行患者静脉自控镇痛,配方为羟考酮50 mg用0.9%氯化钠注射液稀释到100 mL,背景输注速率为0 mL/h,PCA剂量4 mL,锁定时间5 min。记录术后6、12、24、48 h静态、动态VAS评分,术后48 h羟考酮用量、患者满意度评分及不良反应发生情况。结果:与O组比较,TO组术后12 h静态VAS评分、术后6、12、24 h动态VAS评分降低(P<0.05);与O组比较,TO组羟考酮用量降低,患者满意度评分增加,恶心呕吐发生率降低(P<0.05);两组术后头晕、瘙痒、呼吸抑制发生率差异无统计学意义(P>0.05)。结论:腹横肌平面阻滞联合羟考酮静脉自控镇痛可为腹腔镜根治性肾切除术患者提供更加满意的镇痛效果,减少术后阿片类药物用量,并降低术后恶心呕吐的发生率。Objective:To observe the analgesic effect of oxycodone in patient controlled intravenous analgesia combined with transversus abdominis plane block for patient undergoing laparoscopic radical nephrectomy.Methods:Sixty case of American Society of Anesthesiologists(ASA)physical statusⅠorⅡpatients,aged 18~76 years old,scheduled for laparoscopic radical nephrectomy,were randomly assigned into two groups:Transversus abdominis plane block combined with oxycodone in patient controlled intravenous analgesia group(Group TO,n=30)and oxycodone in patient controlled intravenous analgesia group(Group O,n=30).In group TO,transversus abdominis plane block was performed with 0.25%ropivacaine 20 mL.Patient controlled intravenous analgesia was performed after surgery both in group TO and group O.Patient controlled intravenous analgesia solution contained oxycodone 50 mg diluted to 100 mL in 0.9%sodium chloride injection.Patient controlled intravenous analgesia pump was set up to deliver a 4 mL bolus dose with a 5 min lockout interval and no background infusion.The VAS(including VAS at rest and motion)at 6、12、24 and 48 h after surgery was assessed and recorded.The total doses of oxycodone within 48 h after surgery,patient satisfaction and adverse reactions were recorded.Results:Compared with group O,VAS at 12 h after surgery at rest and VAS at 6,12 and 24 h after surgery at motion were decreased in group TO(P<0.05).Compared with group O,total doses of oxycodone within 48 h after surgery and the incidence of postoperative nausea and vomiting were decreased,and patient satisfaction was increased(P<0.05).There was no difference between the two groups in term of the incidence of dizziness,pruritus and respiratory depression(P>0.05).Conclusion:Transversus abdominis plane block combined with oxycodone in patient controlled intravenous analgesia can provide more satisfactory analgesic effect for patient undergoing laparoscopic radical nephrectomy,reduce the requirement of opiods and the incidence of postoperative nausea and vomitin

关 键 词：腹横肌平面阻滞 羟考酮 镇痛 腹腔镜根治性肾切除术 

分 类 号：R737.11[医药卫生—肿瘤]