氨酚羟考酮用于脊柱手术后镇痛临床疗效及安全性评价

Efficacy and safety of oxycodone hydrochloride for postoperative analgesia in spin surgery patients

目的观察氨酚羟考酮用于脊柱手术后镇痛临床疗效及安全性。方法 69例行脊柱外科手术患者分为试验组34例与对照组35例,分别静脉注射氨酚羟考酮和吗啡0.07 mg·kg^(-1)。拔管后开启自控镇痛泵,背景输注速率0.5 mg·h^(-1),吗啡或氨酚羟考酮每次1 mg。比较2组患者入室(T_0),拔管时(T_1),拔管后5 min(T_2),拔管后15 min(T_3)各时点的平均动脉压(MAP)、心率;比较治疗后苏醒时间、拔管时间、视觉模拟评分法(VAS)、警觉/镇静评分(OAA/S)及不良反应发生率。结果 2组患者T_1,T_2,T_3时点MAP及心率水平与T_0时点差异均无统计学意义(P>0.05),且2组患者各时点的上述指标水平差异也均无统计学意义(P>0.05)。试验组患者苏醒时间、拔管时间、VAS评分及OAA/S评分均显著低于对照组(P<0.05)。对照组不良反应总发生率为17.14%(6/35),显著高于试验组的8.82%(3/34)(P<0.05)。结论与吗啡相比,氨酚羟考酮术后镇痛效果更好,不良反应发生率低。

Objective To evaluate the efficacy and safety of oxycodone hydrochloride for postoperative analgesia in patients who received spin surgery. Methods Sixty-nine patients treated with spin surgery were included in this study and randomly divided into treatment group（ n = 34）and control group（ n = 35）. Half an hour before the end of operation,the patients of the two group were given oxycodone hydrochloride and morphine 0. 07 mg · kg^-1,respectively. After extubation,patient-controlled analgesia pump was given with the background dosage of 0. 5mg · h^-1and one time push 1 mg of oxycodone hydrochloride or morphine. The mean arterial pressure（ MAP）,and heart rate were compared in the time points of entering the operation room（ T_0）,tracheal intubation（ T_1）,5 min after tracheal intubation（ T_2）,and 15 min after tracheal intubation（ T_3） between the two groups. The recovery time,extubation time,visual analogue scale（ VAS）,observer assessment of sedation（ OAA/S） score and safety were compared between the two groups.Results The MAP and heart rate were not statistically different between the two groups and among the time points（ P〉0. 05）. The recovery time,extubation time,VAS,OAA / S score in treatment group were significant lower than those of control group（ P〈0. 05）. The adverse drug reactionrates were 17. 14% and 8. 82% in the control group and treatment group respectively with statistical difference（ P〈0. 05）. Conclusion Compared with morphine,oxycodone hydrochloride is more effective and safe for postoperative analgesia in patients who received spin surgery.