预注羟考酮与舒芬太尼在经肝动脉化疗栓塞术中镇痛效果的比较  

Comparison of a single dose of preventive oxycodone and sufentanil on pain during transcatheter arterial chemoembolization

作　　者：许波静 李冰 田伟[2] 吴文涛 XU Bojing;LI Bing;TIAN Wei;WU Wentao(Department of Anesthesiology and Perioperative Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院麻醉与围术期医学科,210029 [2]南京医科大学第一附属医院介入科,210029

出　　处：《临床麻醉学杂志》2024年第12期1264-1268,共5页Journal of Clinical Anesthesiology

基　　金：国家自然科学基金青年项目(81901855)。

摘　　要：目的比较预注羟考酮与舒芬太尼在经肝动脉化疗栓塞(TACE)术中的镇痛效果及其不良反应。方法选择择期局部浸润麻醉下行TACE的患者40例,男37例,女3例,年龄33~81岁,BMI 18.5~30.0 kg/m^(2),ASAⅠ或Ⅱ级。将患者随机分为两组:羟考酮组(O组)和舒芬太尼组(S组),每组20例。术前15 min,O组静脉注射羟考酮0.1 mg/kg;S组静脉注射舒芬太尼0.1μg/kg。记录术中最高VAS疼痛评分,即栓塞即刻、栓塞后5、30 min的VAS疼痛评分中的最高值。记录术后1、6、12、24 h的VAS疼痛评分和上述时点疼痛程度。记录围术期补救镇痛情况,介入医师满意度评分,术前10 min、栓塞后5 min、术后10 min的HR和MAP,恶心、呕吐、头晕、嗜睡、便秘和排尿困难等不良反应的发生情况。结果与S组比较,O组术中最高VAS疼痛评分明显降低(P<0.01),术中无痛率更高(P<0.05),中度疼痛发生率明显降低(P<0.05)。术后1、6、12、24 h两组VAS疼痛评分和疼痛程度差异无统计学意义。与S组比较,O组围术期补救镇痛率明显降低(P<0.01),介入医师满意度评分明显升高(P<0.05),栓塞后5 min MAP明显降低(P<0.05)。两组围术期不良反应差异无统计学意义。两组无一例呼吸抑制发生。结论TACE术前预注单剂量羟考酮,其术中镇痛效果明显优于等效剂量的舒芬太尼。Objective To compare the analgesic effects and adverse events of oxycodone and sufentanil in transcatheter arterial chemoembolization(TACE).Methods Forty patients who underwent selective TACE under local infiltration anesthesia were enrolled in this study,37 males and 3 females,aged 33-81 years,BMI 18.5-30.0 kg/m^(2),ASA physical statusⅠorⅡ.The patients were randomly divided into two groups:the oxycodone group(group O)and the sufentanil group(group S),20 patients in each group.Patients in group O and group S received a single injection of oxycodone 0.1 mg/kg and sufentanil 0.1μg/kg respectively,15 minutes before TACE.Visual analogue scale(VAS)was performed during the operation and at 1 hour,6,12,and 24 hours after TACE.Pain severity was recorded at each time point.The highest intraoperative pain scores were recorded during the three time points,at immediately after embolization,5 minutes after embolization,and 30 minutes after embolization.Need for rescue analgesics,interventional physician satisfaction score,HR and MAP 10 minutes before surgery,5 minutes after embolization,and 10 minutes after surgery,as well as the occurrence of adverse events such as nausea,vomiting,dizziness,drowsiness,constipation,and dysuria were recorded.Results Compared with group S,the highest intraoperative VAS pain score was lower(P<0.01),the incidence of intraoperative painless was higher(P<0.05),and the incidence of intraoperative moderate pain was significantly lower in group O(P<0.05).There were no significant differences in VAS pain score and pain severity between the two groups 1 hour,6,12,and 24 hours after TACE.Compared with group S,the incidence of perioperative rescue analgesia in group O was significantly lower(P<0.01),the interventional physician reported higher degree of satisfaction,MAP was significantly decreased 5 minutes after embolization(P<0.05).There was no statistically significant difference in perioperative adverse events between the two groups.None of the patients in the two groups had respiratory depressio

关 键 词：羟考酮 舒芬太尼 经肝动脉化疗栓塞术 镇痛 

分 类 号：R614[医药卫生—麻醉学]