奥赛利定用于肺部手术后病人自控静脉镇痛的效果  

Efficacy of oliceridine for patient-controlled intravenous analgesia after lung surgery

作　　者：张芸芸 邱郁薇 吴镜湘 Zhang Yunyun;Qiu Yuwei;Wu Jingxiang(Department of Anesthesiology,Shanghai Chest Hospital,Shanghai Jiao Tong University,School of Medicine,Shanghai 200030,China)

机构地区：[1]上海市胸科医院/上海交通大学医学院附属胸科医院麻醉科,上海200030

出　　处：《中华麻醉学杂志》2024年第12期1429-1432,共4页Chinese Journal of Anesthesiology

基　　金：国家自然科学基金面上项目(82071233)。

摘　　要：目的评价奥赛利定用于肺部手术后病人自控静脉镇痛的效果。方法本研究为单中心、回顾性队列研究,选择上海市胸科医院2023年1月1日至2024年8月15日择期行肺部手术并实施了术后自控静脉镇痛的病人,年龄18~80岁,ASA分级Ⅰ-Ⅲ级,性别不限,BMI 18~28 kg/m^(2)。根据病人术后自控静脉镇痛泵内药物成分将病人分为传统阿片类药物(舒芬太尼、氢吗啡酮等)组和奥赛利定组。根据麻醉科专病数据库查阅病人一般资料、手术和麻醉相关资料、术后24 h时VAS评分和阿片类药物相关不良反应。主要指标为术后24 h内病人静态中重度疼痛(VAS评分≥4分)发生率,次要指标为术后24 h内阿片类药物相关不良反应发生率。采用倾向性匹配法调整2组基线数据后进行分析。结果最终2组经匹配后各纳入3053例病人。奥赛利定组病人术后24 h内中重度疼痛发生率较传统阿片类药物组降低(P<0.05),RR=1.298,95%CI:1.120~1.503,P<0.001;奥赛利定组中重度恶心呕吐发生率降低(P<0.05),RR=1.432,95%CI:1.096~1.871,P=0.008。2组术后24 h内头晕和低氧血症发生率比较差异无统计学意义(P>0.05)。结论奥赛利定用于肺部手术后病人自控静脉镇痛的效果优于传统阿片类药物。Objective To evaluate the efficacy of oliceridine for patient-controlled intravenous analgesia(PCIA)after lung surgery.MethodsIn this single-center,retrospective cohort study,patients of either sex,aged 18-80 yr,with American Society of Anesthesiologists Physical Status classificationⅠ-Ⅲ,with a body mass index of 18-28 kg/m^(2),who underwent elective lung surgery with PCIA at Shanghai Chest Hospital from January 1,2023 to August 15,2024,were enrolled.Based on the drug components used in PCIA,patients were divided into traditional opioid group(sufentanil or hydromorphone,etc.)and oliceridine group.Patients′demographics,surgery-and anesthesia-related data,and visual analogue scale scores for pain,and opioid-related adverse reactions at 24 h postoperatively were obtained from the anesthesia specialty database.The primary outcome was the incidence of moderate to severe pain(visual analogue scale score≥4)at rest assessed within 24 h postoperatively.Secondary outcomes were the occurrence of opioid-related adverse reactions within 24 h postoperatively.Data were analyzed after adjusting for baseline imbalances using propensity score matching.ResultsAfter matching,3053 patients were ultimately included in each group.Compared to traditional opioid group,the incidence of moderate to severe pain was significantly decreased within 24 h after surgery(RR:1.298,95%confidence interval:1.120-1.503,P<0.001),and the incidence of moderate to severe PONV was decreased in oliceridine group(RR:1.432,95%confidence interval:1.096-1.871,P=0.008).There was no significant difference in the incidence of dizziness and hypoxemia between the two groups(P>0.05).ConclusionsOliceridine provides better efficacy for PCIA than traditional opioids in patients undergoing lung surgery.

关 键 词：镇痛药 阿片类 肺疾病 外科手术 镇痛 病人控制 

分 类 号：R47[医药卫生—护理学]