盐酸羟考酮注射液不同给药方式单侧甲状腺瘤切除术后镇痛效果

Oxycodone hydrochloride injection different ways of drug delivery analgesia effect after unilateral thyroid adenoma resection

目的观察盐酸羟考酮注射液不同给药方法在全麻甲状腺瘤切除术后的镇痛效果。方法前瞻性收集2015年1～8月内蒙古自治区肿瘤医院收治的符合纳入标准的单侧甲状腺瘤切除手术患者80例。随机分为四组,每组20例。A组于气管插管前静注盐酸羟考酮5mg;B组于气管插管前和手术结束时各静注盐酸羟考酮注射液2.5mg;C组于手术结束时静注盐酸羟考酮注射液5mg;D组于气管拔管后静注盐酸羟考酮注射液5mg。记录术后0、1、4、8、12 h静息状态下的视觉模拟评分法（visual analogue scale,VAS）及术后24h总体镇痛效果评价。记录患者追加镇痛药和不良反应的发生情况。结果术后0、1和4h VAS评分和术后24h总体VAS评分D组明显高于A、B、C组（P﹤0.05）。A、B、C组组间组内VAS评分差异无统计学意义。结论盐酸羟考酮注射液气管插管前和手术结束时分次给药应用于全麻甲状腺切除术后镇痛,使用便捷、效果确切、不良反应少。

Objective This study was carried out in order to study the analgesic effect of oxycodone hydrochloride injection given by different administration methods in the patients undergoing subtotal thyroidectomy. Methods Eighty patients undergoing subtotal thyroidectomy were randomly assigned to four groups. Each group has 20 cases. The patients in group A were injected intravenously oxycodone hydrochloride injection 5 mg before intubation.The patients in group B were injected intravenously oxycodone hydrochloride injection each 2.5 mg before intubation and in the end of the operation. The patients in group C were given intravenous oxycodone hydrochloride injection 5 mg in the end of the operation. The patients in group D were injected intravenously oxycodone hydrochloride injection 5 mg after extubation. The analgesic effect was evaluated by visual analog scales of resting and movement at baseline（O hour）, 1st, 4th, 8th and 12 th hour after surgery,and the postoperative 24-hour total analgesic effect was meansured at the same time. The dose of analgesic drug used postoperatively and the relative side effects were recorded. Results VAS scores of group D were significantly higher than those of group A, B and C at baseline, 1st, and 4th hour（P﹤O.05）. No significant difference existed among the VAS scores of groups A, B and C, although the VAS scores of group B were lower than those of group A and C.The value of total 24 hour analgesic effect after surgery was significantly higher in group D than that in groups A, B and C（P﹤0.05）. The side effects of four groups were similar. Conclusion The analgesia with oxycodone hydrochloride injection is effective and the application of this drug before intubation and in the end of the operation is convenient and safe with few side effect in the patient undergoing subtotal thyroidectomy.