摘要
目的 探讨不同剂量盐酸羟考酮对手助腹腔镜结肠癌根治术患者麻醉苏醒期疼痛的影响。方法 择期行手助腹腔镜结肠癌根治术患者45例,ASA分级Ⅰ~Ⅱ级,采用随机数字法分为观察1组、观察2组和观察3组各15例,分别于手术结束前10min缓慢静脉注射盐酸羟考酮0.05、0.10、0.15mg/kg;术后均给予静脉自控镇痛泵（泵注药物为舒芬太尼＋托烷司琼）镇痛。记录3组拔管时间和苏醒时间;入麻醉恢复室（post anesthesia care unit,PACU）后30min（T1）、60min（T_2）、90min（T3）、出PACU时（T4）视觉模拟评分（visual analogue scale,VAS）、Ramsay镇静评分;比较3组麻醉满意度及不良反应发生情况。结果 观察1组、观察2组、观察3组拔管时间[（15.4±3.9）、（16.1±3.7）、（17.5±4.3）min]、苏醒时间[（17.6±3.7）、（20.8±4.4）、（21.1±4.8）min]比较差异均无统计学意义（P〉0.05）;T_1、T_2、T_3、T4观察2组VAS评分（3.9±0.9、4.0±0.4、3.9±0.5、4.0±0.8）、观察3组VAS评分（4.2±0.7、3.9±0.6、3.8±0.8、3.9±0.6）均低于观察1组（6.4±0.6、5.5±0.8、5.5±0.6、5.5±0.6）（P〈0.05）,观察2组T_1、T_2、T_3、T-4VAS评分与观察3组比较差异无统计学意义（P〉0.05）;3组T_1、T_2、T_3、T_4Ramsay镇静评分比较差异无统计学意义（P〉0.05）;观察2组、观察3组麻醉满意度评分（7.5±0.7、7.4±1.0）均高于观察1组（5.5±0.7）,躁动发生率（6.7%、6.7%）低于观察1组（26.7%）（P〈0.05）。结论 与0.05mg/kg盐酸羟考酮相比,手术结束前10min静脉注射0.10、0.15mg/kg盐酸羟考酮可有效减轻行手助腹腔镜结肠癌根治术患者麻醉苏醒期疼痛,提高麻醉满意度,且不良反应轻。
Objective To investigate the effect of different dose of oxycodone hydrochloride on postoperative pain of hand-assistant laparoscopic radical colectomy. Methods Forty-five patients undergoing hand-assistant laparoscopic radical colectomy, ASA Ⅰ to Ⅱ, were randomly divided into observation 1, 2 and 3 groups receiving intravenous injection of 0.05, 0. 10 and 0. 15 mg/kg oxycodone hydrochloride 10 minutes before the end of surgery. All patients received intravenous self-controlled analgesia pump （sufentanil ± tropisetron） after surgery. The extubation time, awake time, visual analogue scale （VAS） scores and Ramsay sedation scores at the time points of 30 min （TI）, 60 min （T2） and 90 min （T3） after entering post-anesthesia care unit （PACU）, and the time point of leaving PACU （T4） were recorded. The patient satisfaction and adverse reactions were compared among three groups. Results There were no significant differences in the extubation time （（15.4±3. 9）, （16. 1±3. 7）, （17. 5±4. 3） min） and awake time （（17. 6±3. 7）, （20.8±4.4）, （21.1±4.8） min） among observation 1, 2 and 3 groups （P〉0.05）. VAS scores at the time points of T1 , T2, T3 and T4 were significantly lower in observation 2 group （3. 9±0.9, 4.0±0.4, 3. 9±0. 5, 4.0±0. 8） and observation 3 group （4.2±0.7, 3.9±0.6, 3.8±0.8, 3.9±0.6） than those in observation 1 group （6.4±0.6, 5.5± 0.8, 5.5 ±0. 6, 5. 5 ± 0. 6） （P〈0.05）, and there were no significant differences between observation 2 group and observation 3 group （P〉0.05）. There were no significant differences in the Ramsay sedation scores at all time points among three groups （P〉0.05）. The patient satisfaction was significantly higher in observation 2 group （7.5± 0.7） andobservation 3 group （7.4±1.0） than that in observation 1 group （5.5±0.7） at the time point of T4 （P〈0.05）, and the incidence of agitation was significantly lower in observation 2 group （6.7 %） and observation 3 group （6.7 % ） than that in observation 1 group （26. 7%） （P〈0.05）. Conclusion Intravenous injection of 0. 10 or 0. 15 mg/kg oxycodone hydrochloride is superior to intravenous injection of 0.05 mg/kg oxycodone hydrochloride for relieving postoperative pain during hand-assistant laparoscopic radical colectomy and improving patient satisfaction with mild adverse reactions.
出处
《中华实用诊断与治疗杂志》
2016年第8期818-820,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
国家自然科学基金(U1404807)
关键词
盐酸羟考酮
术后疼痛
结肠癌根治术
Oxycodone hydrochloride
postoperative pain
radical colectomy
