奥赛利定用于乳腺癌保乳术病人术后镇痛的效果  

Efficacy of oliceridine for postoperative analgesia in patients undergoing breast-conserving surgery for breast cancer

作　　者：林可欣 王玉艳 周一 卢锡华 李长生 Lin Kexin;Wang Yuyan;Zhou Yi;Lu Xihua;Li Changsheng(Department of Anesthesiology and Perioperative Medicine,the Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450003,China;Department of Anesthesiology and Perioperative Medicine,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学附属肿瘤医院麻醉与围术期医学科,郑州450003 [2]郑州大学第三附属医院麻醉与围术期医学科,郑州450052

出　　处：《中华麻醉学杂志》2024年第12期1441-1445,共5页Chinese Journal of Anesthesiology

摘　　要：目的评价奥赛利定用于乳腺癌保乳术病人术后镇痛的效果。方法本研究为前瞻性、随机、双盲、单中心、阳性对照研究。选择2024年5月至8月于郑州大学附属肿瘤医院在全身麻醉下行乳腺癌保乳术病人123例,年龄18~64岁,ASA分级Ⅰ或Ⅱ级,BMI 18~28 kg/m^(2),采用随机数字表法分为2组:舒芬太尼组(S组,n=62)和奥赛利定(O组,n=61)。麻醉诱导时:S组静脉注射舒芬太尼15μg,O组静脉注射奥赛利定3 mg;切皮前2 min时:S组静脉注射舒芬太尼10μg,O组静脉注射奥赛利定2 mg。术后行病人自控静脉镇痛,S组采用舒芬太尼50μg,O组采用奥赛利定10 mg,分别用生理盐水配至100 ml。分别于术后6、12、24和48 h时记录静态和动态疼痛视觉模拟量表(VAS)评分;记录术后首次按压镇痛泵时间、术后24 h内镇痛泵有效按压次数和补救镇痛情况;分别于气管拔管后5、15和30 min时记录Ramsay镇静评分;分别于术前24 h和术后24、48 h时行15项恢复质量量表(QoR-15)评分。记录术后48 h内不良反应发生情况。结果与S组相比,O组不同时点静态和动态VAS评分、术后首次按压镇痛泵时间、术后24 h内镇痛泵有效按压次数和补救镇痛率,以及气管拔管后5、15和30 min时Ramsay评分差异均无统计学意义(P>0.05),术后24和48 h时QoR-15评分升高,术后恶心呕吐发生率降低(P<0.05)。结论奥赛利定用于乳腺癌保乳术病人,可产生与舒芬太尼相当的术后镇痛效果,且不影响病人苏醒,还可减少术后恶心呕吐发生,有利于术后早期恢复。Objective To evaluate the efficacy of oliceridine for postoperative analgesia in patients undergoing breast-conserving surgery for breast cancer.MethodsIn this prospective,randomized,double-blind,single-center,positive-control clinical study,123 patients with breast cancer,aged 18-64 yr,of American Society of Anesthesiologists Physical Status classification I orⅡ,with a body mass index of 18-28 kg/m^(2),undergoing breast-conserving surgery under general anesthesia at the Affiliated Cancer Hospital of Zhengzhou University from May to August 2024,were divided into 2 groups using a random number table method:sufentanil group(group S,n=62)and oliceridine group(group O,n=61).During anesthesia induction,sufentanil 15μg was intravenously injected in group S,and oliceridine 3 mg was intravenously injected in group O.At 2 min before skin incision,sufentanil 10μg was intravenously injected in group S,and oliceridine 2 mg was intravenously injected in group O.Postoperative patient-controlled intravenous analgesia was performed,with group S receiving sufentanil 50μg and group O receiving oliceridine 10 mg,each diluted with normal saline to 100 ml.The pain visual analog scale scores at rest and during activity were recorded at 6,12,24 and 48 h postoperatively.The time of the first pressing of the postoperative analgesic pump,effective pressing times of patient-controlled analgesia and requirement for rescue analgesia within 24 h after surgery were recorded.The Ramsay sedation scores were recorded at 5,15 and 30 min after tracheal extubation.The postoperative recovery quality was measured using the 15-item quality of recovery questionnaire at 24 h before surgery and at 24 and 48 h after surgery.The adverse reactions were recorded within 48 h after surgery.ResultsCompared with group S,no significant change was found in visual analog scale scores at rest and during activity at different time points,the time of the first pressing of the postoperative analgesic pump,effective pressing times of patient-controlled analgesia and

关 键 词：镇痛药 阿片类 镇痛 乳腺肿瘤 

分 类 号：R61[医药卫生—外科学]