盐酸羟考酮用于预防全麻术后围拔管期应激反应的有效性和安全性

Efficacy and Safety of Oxycodone Hydrochloride Injection Anesthesia for the Prevention of Postoperative Extubation Stress Response

目的:探讨不同剂量盐酸羟考酮注射液用于预防全麻术后围拔管期应激反应的有效性和安全性。方法:选取ASAⅠ-Ⅱ级全麻下腹部手术患者80例。随机分为4组:对照组(生理盐水,C)、羟考酮低(5mg,O1)、中(10mg,O2)、高(15mg,O3)剂量组。在手术结束前5min分别给予低、中、高剂量实验组静注羟考酮5,10,15mg,对照组给予生理盐水10ml。记录全麻苏醒期不同观察时间点的生命体征,记录术后自主呼吸恢复时间、睁眼时间、拔管时间及气管拔管并发症和盐酸羟考酮不良反应发生率,并于各时间点抽取静脉血,采用葡萄糖氧化酶法测定血糖,放射免疫法检测皮质醇浓度。结果:O1组、O2组和O3组在手术后平均动脉压(MAP)、心率(HR)均低于C组,差异具有统计学意义;O2组与O3组最低,O1组次之,且O2与O3组间比较无统计学意义。C组、O1组在手术后血糖、皮质醇均明显升高,差异具有统计学意义(P<0.05),O2、O3无明显变化(P>0.05),且C与O1、O2与O3,组间比较无统计学意义(P>0.05);与C组比较,O2、O3组呛咳、烦躁、拔管不良记忆等不良反应发生率明显降低(P<0.05);O3组呼吸抑制发生率明显升高(P<0.05)。结论:手术结束前5min静脉注射10mg盐酸羟考酮对预防、减轻全麻术后拔管时的应激反应最为有效安全。

Objective： To investigate different doses of oxycodone hydrochloride injection anesthesia for the prevention of postoperative extubation stress response of efficacy and safety. Methods： 80 ca- ses of patients udergoing ASA grade Ⅰ-Ⅱ anesthesia abdominal surgery were randomly divided in- to four groups： control group （saline, C）, oxycodone low （5 mg, 01）, medium （10 mg, O2）, and high dose group（15 mg, 03）. The experimental group were given low, medium and high do- ses of intravenous oxycodone of 5 mg, 10 mg, and 15 mg 5 min before the end of surgery, while the control group received 10 ml of saline. Records were taken for vital signs of general awaken- ing period at different observation time points, postoperative spontaneous breathing recovery time, eye opening time, extubation time and complications and tracheal extubation as well as inci- dence of adverse reactions of oxycodone hydrochloride. Venous blood was taken in all time pointsand blood sugar was evaluated by glucose oxidase method, ortisol concentration was detected by radioimmunity method. Results： Heart rate （HR） and arterial pressure （MAP） in groups O1, O2 and O3 were lower than that in group C after nificant; Groups O2 and O3 were the lowest, statistical significance between groups O2 and rose significantly after surgery, the difference surgery, which the difference was statistically sig- group O1 took the second place, and there was no O3. Blood glucose and cortisol in groups C and O1 was statistically significant （P〈0.05）, there was no significant change in 02 and 03 groups （P〉0.05）. Compared with those in group C, cough, irritability, poor memory and occurance of adverse reaction rate in groups O1, O2 and O3 signifi- cantly decreased（P〈0.05）; The incidence of respiratory depression in group O3 was significantly higher （P〈0.05）. Conclusion ： Intravenous injection fore the end of surgery is most effective and safe for extubation after general anesthesia. 10 mg of oxycodone hydrochloride 5 min be- preventing and reducing the stress response