摘要
目的评估盐酸羟考酮注射液用于术后患者静脉自控镇痛(PCIA)的镇痛效能及不良反应。方法检索北京协和医院麻醉科术后镇痛记录系统,回顾性分析手术日期在2018年1月1日至6月30日期间的术后镇痛记录,对比使用盐酸羟考酮组、舒芬太尼组和吗啡组患者术后24、36、48 h镇痛药累计用量、静息状态及下床活动时的疼痛评分、相应曲线下面积(AUC)和术后48 h内不良反应。结果术后36 h,羟考酮组患者的活动时疼痛评分为(2.2±2.4)分,明显低于舒芬太尼组的(3.4±2.1)分(t=0.305,P=0.0126)和吗啡组的(3.4±1.7)分(t=0.104,P=0.0277)。静息状态下,羟考酮组和吗啡组的AUC分别为29.00和27.00,低于舒芬太尼组的40.01;下床活动时,羟考酮组的AUC为63.17,低于吗啡组的80.93和舒芬太尼的82.00。术后24、36、48 h,舒芬太尼组患者等效吗啡累计量分别为(37.2±16.1)、(46.1±24.3)、(64.4±33.4)mg,明显高于羟考酮组的(20.4±14.8)(t=3.571,P=0.001)、(24.2±16.1)(t=4.630,P<0.0001)、(34.4±25.1)mg(t=6.409,P<0.0001)和吗啡组的(16.6±11.7)(t=4.233,P<0.0001)、(20.50±14.1)(t=5.250,P<0.0001)、(28.8±19.0)mg(t=7.354,P<0.0001);羟考酮组和吗啡组间差异均无统计学意义(P均>0.05)。羟考酮组出现恶心(χ^2=11.360,P=0.003)及提前终止镇痛患者的比例(χ^2=7.914,P=0.019)明显低于其他两组。结论盐酸羟考酮注射液可用于术后PCIA,缓解多种手术的术后疼痛,其镇痛效能优于吗啡及舒芬太尼,恶心呕吐发生率低。
Objective To evaluate the value of oxycodone hydrochloride for postoperative pain management in patients undergoing patient-controlled intravenous analgesia(PCIA).Methods The medical records on postoperative pain management in our department from January 1 to June 30,2018,were retrospectively analyzed.Totally 136 patients were assigned into oxycodone,sufentanil,or morphine groups according to the opioid used in the PCIA.Patients were assessed for postoperative pain severity(scored with NRS)and adverse reactions 24,36,and 48 hours after surgery.The area under curve(AUC)was calculated.Results The score of pain at exercise was significantly lower in the oxycodone group(2.2±2.4)than in the sufentanil group(3.4±2.1)(t=0.305,P=0.0126)or the morphine group(3.4±1.7)(t=0.104,P=0.0277)36 hours after surgery.AUC at rest was significantly lower in the oxycodone and morphine groups than in the sufentanil group(29.00,27.00,and 40.01,respectively);in contrast,AUC at exercise was significantly lower in the oxycodone group(63.17)than in the sufentanil and morphine groups(82.00 and 80.93,respectively).The consumption of opioids was significantly higher in the sufentanil group[(37.2±16.1),(46.1±24.3),(64.4±33.4)mg]than in the oxycodone group[(20.4±14.8)(t=3.571,P=0.001),(24.2±16.1)(t=4.63,P<0.0001),(34.4±25.1)mg(t=6.409,P<0.0001)]or the morphine group[(16.6±11.7)(t=4.233,P<0.0001),(20.5±14.1)(t=5.250,P<0.0001),(28.8±19.0)mg(t=7.354,P<0.0001)]24,36,48 hours after surgery.The oxycodone group experienced less vomiting(χ^2=11.360,P=0.003)and early termination of PCIA(χ^2=7.914,P=0.019)compared with the other two groups.Conclusions Oxycodone can be used for postoperative PCIA.It can alleviate a variety of postoperative pain,with superior analgesic efficiency and safety to sufentanil and morphine.
作者
王维嘉
任立英
龚亚红
黄宇光
WANG Weijia;REN Liying;GONG Yahong;HUANG Yuguang(Department of Anesthesiology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Operating Room,PUMC Hospital,CAMS and PUMC,Beijing 100730,China)
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2020年第1期91-95,共5页
Acta Academiae Medicinae Sinicae
关键词
术后疼痛
患者自控静脉镇痛
盐酸羟考酮
阿片类药物
postoperative pain
patient-controlled intravenous analgesia
oxycodone hydrochloride
opioids
