羟考酮抑制妇科手术后疼痛的半数有效剂量

The median effective dose of oxycodone for postoperative analgesia in women underwent gynecologic surgery

目的探讨妇科患者术后羟考酮镇痛半数有效剂量(ED50)。方法择期全凭静脉全麻下行妇科手术患者30例,手术关腹时给予羟考酮术后镇痛。术前采用神经肌肉刺激仪测定患者的痛阈值;术后30min行VAS疼痛评分评估镇痛效果,以VAS疼痛评分<4分为羟考酮镇痛有效。采用序贯法等比增减方法用药,首例剂量0.1mg/kg,相邻病例的剂量比为1.1。采用概率单位计算法计算羟考酮镇痛ED50及其95%可信区间。记录患者的苏醒时间。结果羟考酮有效组患者16例。羟考酮术后镇痛ED50为0.11mg/kg,95%可信区间为(0.07-0.14)mg/kg。患者中位苏醒时间为12min。结论手术关腹前给予羟考酮术后镇痛的ED50为0.11mg/kg,不影响苏醒。

Objective To determine the median effective dose （ED50） of oxycodone for postoperative analgesia in women underwent gynecologic surgery. Methods Thirty patients were operated upon for gynecologic surgery under total intravenous anesthesia. The threshold of pain was assessed with nerve muscle stimulator before operation. The degree of pain was evaluated using VAS at 30 mins after surgery and VAS score〈4 was taken as effective analgesia of oxycodone. Oxycodone was administrated before abdomen closure in an initial dose of 0.1 mg/kg in the first case. The next dose of oxycodone for the adjacent cases was increased or decreased by sequential method with a ratio of 1.1 between two adjacent cases. The ED50 of oxycodone for postoperative analgesia and 95% confidence interval were calculated by probit method. Results The effective analgesia was seen in 16 cases. The ED50 of oxycodone for postoperative analgesia was 0. 11 mg/kg with 95% confidence interval of （0. 07-0. 14） mg/kg. The average duration from the end of surgery to extubation was 12 min. Conclusion The EI-0 of oxycodone for postoperative analgesia given before abdomen closure is 0. 11 mg/kg without effect on awakening in women underwent gynecologic surgery.