羟考酮预防全麻患者麻醉恢复期导尿管相关膀胱刺激征的效果

Efficacy of oxycodone in preventing catheter-related bladder discomfort during recovery from anesthesia in patients undergoing general anesthesia

目的 评价羟考酮预防全麻患者麻醉恢复期导尿管相关膀胱刺激征（CRBD）的效果.方法 择期全麻下拟行脊柱手术男性患者155例,年龄18～ 60岁,体重46～ 75 kg,ASA分级Ⅰ或Ⅱ级.采用随机数字表法分为3组：对照组（C组,n=52）、羟考酮组（O组,n=51）和舒芬太尼组（S组,n=52）.手术结束前15 min时O组静脉注射羟考酮0.07 mg/kg,S组静脉注射舒芬太尼0.10 μg/kg,C组给予等容量生理盐水.记录苏醒时间和气管拔管时间;分别于拔除气管导管后5 min（T1）、15 min（T2）、30 min（T3）、1 h（T4）、2 h（T5）和4 h（T6）时记录Riker镇静-躁动评分.记录术后4h内CRBD的发生情况及程度,以及恶心呕吐和呼吸抑制的发生情况.结果 与C组比较,S组T1-4时Riker镇静-躁动评分、CRBD发生率和程度降低,苏醒时间和气管拔管时间延长,O组T1-6时Riker镇静-躁动评分、CRBD发生率和程度降低（P＜0.05）,苏醒时间和气管拔管时间差异无统计学意义（P＞0.05）;与S组比较,O组T1.时Riker镇静-躁动评分升高,T5-6时Riker镇静-躁动评分、CRBD发生率和程度降低,苏醒时间和气管拔管时间缩短（P＜0.05）.3组恶心呕吐和呼吸抑制发生率比较差异无统计学意义（P＞0.05）.结论 手术结束前15 min静脉注射羟考酮0.07 mg/kg可预防全麻患者麻醉恢复期CRBD的发生.

Objective To evaluate the efficacy of oxycodone in preventing catheter-related bladder discomfort （CRBD） during recovery from anesthesia in the patients undergoing general anesthesia.Methods A total of 155 male patients, aged 18-60 yr, weighing 46-75 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective spinal surgery performed under general anesthesia, were randomly divided into 3 groups： control group （group C, n =52）, oxycodone group （group O, n=51）, and sufentanil group （group S, n=52）.After induction of anesthesia, the patients were tracheally intubated and mechanically ventilated.At 15 min before the end of surgery, oxycodone 0.07 mg/kg was injected intravenously in group O, sufentanil 0.10 μg/kg was injected intravenously in group S, and the equal volume of normal saline was given in group C.The emergence time and extubation time were recorded.Riker sedation-agitation scale （SAS） score was recorded at 5, 15 and 30 min, and 1, 2 and 4 h after extubation （T1-6）.The occurrence and severity of CRBD within 4 h after surgery, and occurrence of nausea and vomiting and respiratory depression were observed and recorded.Results Compared with group C, the SAS score at T1-4 and incidence and severity of CRBD were significantly decreased, and the emergence time and extubation time were prolonged in group S, and the SAS score at T1-6 and incidence and severity of CRBD were significantly decreased （P〈0.05） , and no significant change was found in emergence time and extubation time in group O （P〉0.05）.Compared with the group S, the SAS score at T1-4 was significantly increased, the SAS score at T5-6 and incidence and severity of CRBD were decreased, and the emergence time and extubation time were shortened in group O （P〈0.05）.There was no significant difference in the incidence of nausea and vomiting and respiratory depression between the three groups （P〉0.05）.Conclusion Oxycodone 0.07 mg/kg injected intravenously at 15 min before the end of surgery can prevent the occurrence of CRBD during recovery from anesthesia in the patients undergoing general anesthesia.