羟考酮联合尼松在肝癌切除术后镇痛中的应用

Application of Ketorolac Tromethamine Injeton Combined with Oxycodone for Postoperative Analgesia in the Resection of Liver Cancer

目的观察羟考酮联合尼松对肝癌切除术后镇痛的效果。方法选择行择期肝癌切除术患者60例,随机均分为2组:尼松+羟考酮组(KO组)和尼松+芬太尼组(KF组)。2组手术结束前30 min均给予尼松30 mg预先镇痛,手术结束时2组患者分别静脉注射羟考酮10 mg、芬太尼0.1 mg,术后均用舒芬太尼2μg·kg-1和托烷司琼10 mg,生理盐水稀释至200 m L入镇痛泵。评估2组患者在入麻醉复苏室(PACU)醒后30 min、60 min和离开PACU时的深腹部疼痛强度NRS评分,追加镇痛药物和上腹部不适等的发生情况。结果与KF组比较,KO组术后不同时点NRS评分均明显降低(P<0.05);镇痛药物追加例数明显减少(P<0.05);上腹部不适感发生率明显降低(P<0.05)。结论羟考酮联合尼松的术后镇痛方案安全可行,可为肝癌切除术患者提供有效的术后镇痛,且不良事件少,更有利于患者术后康复。

Objective To observe the efficacy of ketorolac tromethamine injeton combined with oxycodone for postoperative analgesia in the resection of liver cancer. Methods Sixty patients received resection of liver cancer were randomly divided into two groups：the ketorolac tromethamine injeton plus oxycodone group （ the KO group） and the ketorolac tromethamine injeton plus fentanil group （the KF group）. Patients in the KO group received 10 mg oxycodone,and patients in the KF group received 0.1 mg fentanil before skin closure. In the 30 minutes before the end of surgery ,all the patients received 30 mg ketorolac tromethamine injeton and controlled intravenous analgesia with sufentanil 2μg·kg^-1 plus 10 mg tropisetron diluted to 200 mL with normal saline. The NRS scores （30 min, 60 min postoperatively and after PACU） , additional analgesic drugs and complications were compared. Results Compared with the KF group, the NRS scores, additional analgesic drugs and complications were significantly decreasd in the KO group （ P 〈 0. 05 ）. Conclusion The combination of ketorolac tromethamine injeton and oxycodone can pro- vide more effective postoperative analgesia to patients, as well as less complications in the resection of liver cancer.