吗啡与羟考酮用于经皮肾镜取石术后镇痛效果比较

Comparison of Postoperative Analgesia Efficacy of Morphine Versus Oxycodone After Percuta-neous Nephrolithotomy

【目的】对比研究吗啡与羟考酮用于经皮肾镜碎石取石术（PCNL）后的镇痛效果。【方法】回顾性分析2013年10月至2014年9月在本院行PCNL术治疗的50名患者，根据术后给予不同的镇痛药物将患者分为吗啡组（25例）和羟考酮组（25例）。比较两组患者术后4 h镇痛药物的使用量、疼痛视觉模拟评分（VAS）及不良反应（如恶心，头晕，呼吸抑制和瘙痒）等指标。【结果】两组患者VAS评分及镇痛药的平均使用量均无统计学差异（P ＞0．05），吗啡组患者不良反应恶心的发生率明显少于羟考酮组（P ＜0．05）。【结论】吗啡与羟考酮对行PCNL术的患者镇痛效果相当，但吗啡较羟考酮可减少不良反应恶心的发生率。

[Objective] To compare the analgesia efficacy of morphine versus oxycodone after percutaneous nephrolithotomy （PCNL） .[Methods] The opioid consumption ,pain relief and side effects of morphine versus oxycodone after PCNL were examined by minimizing somatic pain component .During October 2013 and Sep‐tember 2014 ,a total of 50 adult patients were recruited and randomized to receive either morphine or oxycodo‐ne intravenously as postoperative pain treatment .During the first 4 postoperative hours ,opioid consumption , pain scores and side effects （nausea ,dizziness ,respiratory effects ＆amp; itching ） were recorded .[Results] The postoperative opioid consumption varied considerably .However ,the mean opioid consumption was comparable for two groups （ P〉 0 .05） .Nausea was significantly less frequent with morphine （ P〈0 .05） .[Conclusion]Morphine and oxycodone have similar analgesia efficacies during the first 4 postoperative hours .However ,the frequency of nausea is significantly less for morphine users .