羟考酮与舒芬太尼超前镇痛用于瑞芬太尼腹腔镜胆囊切除术的比较

Effect of preemptive analgesia with oxycodone and sufentanil in laparoscopic cholecystectomy

目的评价羟考酮用于腹腔镜胆囊切除术超前镇痛的效果及安全性。方法选择择期行腹腔镜胆囊切除术患者60例,随机分成两组(I组羟考酮组,II组舒芬太尼组),全麻醉诱导前5min分别给于0.1mg/kg羟考酮,0.1μg/kg舒芬太尼。手术结束后记录拔出喉罩所用时间,手术结束后2h患者镇静程度,静息与咳嗽时疼痛程度,分别用Ramsay评分法及NRS(numerical rating scale,数字评分法)评估,并记录术后6h时两组患者恶心呕吐、皮肤瘙痒、呼吸抑制及寒颤情况。结果两组患者术后拔除喉罩时间,术后2h镇静及镇痛评分均无统计学意义(P>0.05)。术后6h皮肤瘙痒,呼吸抑制及寒颤两组患者比较无统计学意义(P>0.05),恶心呕吐发生率I组>II组,差异有统计学意义(P<0.05)。结论羟考酮超前镇痛用于腹腔镜胆囊切除术,能有效缓解术后疼痛。

Objective To observe the efficacy and safety of preemptive analgesia with oxycodone and sufentanil in lapa- roscopic eholeeysteetomy with propofol combined with remifentanil anesthesia. Methods Totally 60 patients were ran- domly divided into two groups ：oxycodone group （group Ⅰ ） and sufentanil group （group Ⅱ）. Five minutes before the induc- tion ,0.1μg/kg were injected with oxycodone in group Ⅰ and 0. 1μg/kg were injected with sufentanil in group Ⅱ. After the operation, removal time of laryngeal mask, the degree of sedation and pain with resting and cough were assessed with nu- merical rating scale （NRS） and visual analogue score （VAS） at two hous after operation. Nausea and vomiting, skin itching, respiratory depression and shivering were recorded after 6h. Results There were no significant differences in the incidence of removal time of laryngeal mask, the degree of sedation and pain with resting and cough （ P 〉 0. 05 ）. Compared with two groups, there were no significant differences in the incidence of Nausea and vomiting, skin itching, respiratory depression and shivering were recorded after 6h. （ P 〉 0. 05 ）. But Oxycodone group showed more nausea at 6h after the operation（ P 〈 0. 05 ）. Conclusion Preemptive analgesia with oxyeodone in laparoscopic choleeystectomy, can effectively relieve postoperative pain.