盐酸羟考酮超前镇痛在腹腔镜直肠癌手术全麻苏醒期的临床效果

The effects of preemptive analgesia with oxycodone injection on the anesthesia recovery period for patients undergoing laparoscopic colorectal cancer surgery

1目的观察盐酸羟考酮超前镇痛在腹腔镜直肠癌手术患者全麻苏醒期的临床镇痛效果。2方法选择全麻下进行腹腔镜直肠癌手术的患者60例,采用随机数字表法将其分为两组,各30例,即盐酸羟考酮组(Q组),芬太尼组(F组)。常规进行麻醉诱导,用七氟醚、丙泊酚和瑞芬太尼进行术中维持,手术结束前15分钟分别给予Q组盐酸羟考酮0.1mg/kg,F组芬太尼1μg/kg。术毕送到麻醉后复苏室(PACU)进行复苏,记录患者的手术时间和麻醉时间及进入复苏室后的自主呼吸恢复时间、苏醒时间、拔管时间,记录患者入复苏室(T0)、拔管时(T1)、拔管后5分钟(T2)、拔管后15分钟(T3)的心率(HR)、血氧饱和度(SpO2)和平均动脉压(MAP)及各时点的视觉模拟评分(VAS)及镇静评分(Ramsay),记录患者苏醒期出现的不良反应。3结果 Q组自主呼吸恢复时间、拔管时间及苏醒时间均较F组短,差异有统计学意义(P<0.05);两组患者各时点的MAP、HR比较差异无统计学意义,且变化趋势相同;在T2时,Q组患者的SpO2较F组高,差异有统计学意义(P<0.05);在T3时Q组VAS评分明显低于F组,差异有统计学意义(P<0.05),Q组的Ramsay评分在T0、T1、T2时间点均明显低于F组,差异有统计学意义(P<0.05)。4结论盐酸羟考酮超前镇痛应用于腹腔镜直肠癌手术患者全麻苏醒期是安全有效的,0.1mg/kg能够提供有效的镇痛,有利于维持患者苏醒期的血流动力学稳定,保护患者全麻苏醒期的安全。

Objective To observation the effects of preemptive analgesia with oxycodone injection on the anesthesia recovery period for patients undergoing laparoscopic colorectal cancer surgery.Methods A total of 65 patients were selected from laparoscopic colorectal cancer surgery under general anesthesia,according to the exclusion criteria,finally selected 60 cases.They were divided into two groups by random number method：oxycodone hydrochloride injection group（Q group,n =30）,fentanyl group（F group,n =30）,general anesthesia induction,with sevoflurane and propofol and fentanyl for intraoperative maintain,15 min uters before the end of surgery were given Q group of 0.1mg/kg,fentanyl 1ug/kg.Patients were Putten into PACU for recovery.Recorded patients＇ surgery time and anesthesia time,recovery time of the spontaneous breathing,extubation time,recording the the patient into the recovery room（T0）,tube drawing time（T1）,5min uters after extubation（T2）,15 minuters after the extubation（T3）of heart rate（HR）,blood oxygen saturation（SpO2）and mean arterial pressure（MAP）and each point of the visual analogue scale（VAS）and sedation score（Ramsay）,recording the awakening period in patients with adverse reactions.Results Spontaneous breathing recovery time and extubation time and awakening time in Q group were shorter than F group,the difference was statistically significant（P〈0.05）;Two groups of patients with each point of the MAP,HR,there was no statistically significance（P〉0.05）difference comparison,and Two groups of patients with HR,MAP,changing trend was the same.While at the T2,Q group of patients with SpO2 from F group the comparison,the difference was statistically significant（P〈0.05）;Q group in T3 VAS score was lower than that in F group（P〈0.05）,the difference was statistically significant,Q group in Ramsay score at T0,T1 and T2time points were significantly lower than F group（P〈0.05）,the difference was statistically significant.Conclusion Compared with fentanyl,oxycodone hydrochloride injection analgesia applied in laparoscopic colorectal cancer surgery patients in advance of general awakening period are effective,0.1mg/kg can provide effective analgesia,beneficial to maintain the awaking period in patients with stable hemodynamics,to ensure the safety of the patients in general awakening period.