羟考酮在老年女性非体外循环冠脉旁路移植术后镇痛的临床效果观察  

The clinical effect observation on analgesic effect of oxycodone after off-pump coronary artery bypass grafting in elderly women

作　　者：邹璐雯 叶伟光[1] 马艳辉[1] 徐娜[1] 李洪利[2] 李超 王天龙[1] Zou Luwen;Ye Weiguang;Ma Yanhui;Xu Na;Li Hongli;Li Chao;Wang Tianlong(Department of Anesthesiology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院麻醉科,北京100053 [2]首都医科大学宣武医院心脏外科,北京100053

出　　处：《北京医学》2023年第11期953-956,共4页Beijing Medical Journal

摘　　要：目的探讨羟考酮在老年女性非体外循环冠脉旁路移植(off-pump coronary artery bypass grafting,OPCABG)术后患者自控静脉镇痛(patient-controlled intravenous analgesia,PCIA)的效果及安全性。方法选取2021年10月至2022年12月首都医科大学宣武医院择期行OPCABG的老年女性患者64例,采用随机数字表法随机分为羟考酮组(O组)和舒芬太尼组(S组),每组32例。两组术后采用不同的PCIA方法,比较两组患者气管拔管时(T1),拔管后6 h(T2)、12 h(T3)、24 h(T4)和48 h(T5)的视觉模拟评分(visual analogue scale,VAS)和Ramsay镇静评分,并记录拔管后48 h内的PCIA有效按压次数、补救镇痛药使用率和镇痛相关并发症情况。结果64例患者平均年龄(68.0±3.5)岁,两组各时点的VAS、Ramsay镇静评分、自控按压次数、补救镇痛率、术后皮肤瘙痒及眩晕发生率的差异无统计学意义(P>0.05)。与O组相比,S组恶心呕吐发生率(34.4%比12.5%)及排气时间[(32.3±9.2)h比(25.5±6.1)h]均较高,差异有统计学意义(P<0.05)。结论与舒芬太尼相比,羟考酮用于老年女性OPCABG术后PCIA效果良好,且胃肠道不良反应较轻。Objective To explore the effect and safety of oxycodone in patient-controlled intravenous analgesia(PCIA)after off-pump coronary artery bypass grafting(OPCABG)in elderly women.Methods Sixty-four elderly women undergoing OPCABG in Xuanwu Hospital of Capital Medical University from October 2021 to December 2022 were selected,and were randomly divided into oxycodone group(group O)and sufentanil group(group S),with 32 cases in each group.The two groups were treated with different PCIA formula.The visual analogue scale(VAS)and the Ramsay sedation score was compared between the two groups at the time of tracheal extubation(T1),and 6 h(T2),12 h(T3),24 h(T4),48 h(T5)after extubation,and the effective times of PCIA compression,the utilization rate of remedial analgesics and the related complications of analgesia within 48 h were also recorded and compared between the two groups.Results The average age of the 64 patients was(68.0±3.5)years old.There were no significant differences in VAS,Ramsay sedation score,the number of self-controlled compression times,the rate of remedial analgesia,and the incidence of postoperative skin itching and dizziness between the two groups(all P>0.05).Compared with group O,the incidence of nausea and vomiting(34.4%vs.12.5%)and the exhaust time[(32.3±9.2)h vs.(25.5±6.1)h]in group S were higher,with statitical significance(both P<0.05).Conclusions Compared with sufentanil,oxycodone is effective in PCIA for elderly women after OPCABG,and the gastrointestinal side effect is mild.

关 键 词：羟考酮 非体外循环冠脉旁路移植术 自控静脉镇痛 老年 女性 

分 类 号：R614[医药卫生—麻醉学]