盐酸羟考酮与地佐辛超前镇痛用于上腹部手术的比较

Comparison of oxycodone hydrochloride and dezocine preemptive analgesia for upper abdominal operation

目的:探讨盐酸羟考酮、地佐辛用于上腹部手术超前镇痛的效果及安全性。方法:择期上腹部手术80例,随机分为羟考酮组(O组)和地佐辛组(D组),手术结束前30min分别静脉注射盐酸羟考酮注射液和地佐辛注射液0.01mg/kg,观察苏醒期血流动力学指标、苏醒时间、拔管时间、疼痛视觉模拟评分(VAS)、舒适度(BCS)、苏醒期躁动(EA)和药物不良反应。结果:两组患者MAP、HR、苏醒时间、拔管时间及EA发生率差异无统计学意义(P>0.05);O组术后T1(拔管时)、T2(拔管后5min)、T3(拔管后15min)、T4(拔管后30min)时点的VAS评分低于D组(P<0.05),BCS评分高于D组(P<0.05),困倦率低于D组;恶心呕吐发生率无统计学意义,两组均未出现呼吸抑制。结论:手术结束前30min静脉注射盐酸羟考酮注射液0.01mg/kg不影响上腹部患者苏醒,能减轻疼痛反应,且不良反应少。

Objective： To evaluate the clinical efficacy and safety of oxycodone in preemptive analgesia for upper abdominal surgery. Methods： Selecting eighty patients with upper abdominal surger randomly dividing them into two groups： Oxycodone group（ Group O,n = 40） and dezocine group（ Group D,n = 40）. 30 minutes before the surgery,group O（ n = 40） was injected with oxycodone（ 0. 01 mg / kg,iv）,and group D（ n = 40） injected dezocine（ 0. 01 mg /kg,iv）. To observe hemodynamic index during recovery,recovery time,extubation time,VAS,and BCS. Emergence agitation and adverse events such as respiratory depression,nausea and vomiting,drowsiness,and pruritus were assessed. Results： The changes of MAP and HR,recovery time,and the incidence of emergence agitation showed no significant difference between the two groups（ P〉 0. 05）. Group O T1（ extubation）,T2（ extubation 5 min）,T3（ extubation 15 min）,T4（ extubation 30 min） point of VAS score were lower than that of group D（ P〈 0. 05）,BCS score higher than that of group D（ P〈 0. 05）,drowsiness rate was lower than that of group D. The incidence of nausea and vomiting showed no significant difference between the two groups. There was no respiratory depression in two groups.Conclusion： Compared with morphine,oxycodone hydrochloride injection,with less adverse effects,has no influence on analepsia of patients with upper abdominal surgery and can effectively relieve pain.