羟考酮和舒芬太尼在腹腔镜胆囊切除术后静脉自控镇痛的比较

Comparison of oxycodone hydrochloride injection versus sufentanil for postoperative analgesia in patients undergoing laparoscopic cholecystectomy operation

目的：比较羟考酮和舒芬太尼用于腹腔镜胆囊切除术（LC）术后镇痛效果。方法：择期行LC 患者60例，年龄18～65岁，性别不限，体重46～85 kg ，随机分为两组各30例。手术结束前5 min开启PCIA泵行术后镇痛：羟考酮20 mg（Q组）或舒芬太尼100μg（S组）加生理盐水稀释至100 mL，首次量10 mL，持续量2 mL／h，PCA量5 mL／次。记录术后1、6、24 h静态和动态NRS疼痛评分，24 h内镇痛泵药液消耗量，镇痛满意度，不良反应发生率。结果：两组各时点静态和动态NRS评分、24 h内镇痛泵药液消耗量、恶心呕吐发生率差异无统计学意义。与S组比较，Q组患者满意度明显升高（P ＜0．05），头晕发生率明显降低（P ＝0．022）。结论：羟考酮可以安全有效用于LC后PCIA镇痛，与舒芬太尼相比头晕发生率低，患者满意度高。

Objective To compare the effects of oxycodone hydrochloride injection versus sufentanil for postoperative analgesia in patients undergoing laparoscopic cholecystectomy （LC） operation. Methods Sixty patients of both sexes , aged 18-65 yr , weighing 46-85 kg , scheduled for LC operation , were randomly divided into 2 groups （n = 30）. Patient-controlled intravenous analgesia （PCIA） pump （oxycodone hydrochloride injection 20 mg or sufentanil 100 μg with physiological saline to 100 ml ） was used for postoperative analgesia five minutes before the end of operation. The first dose and bolus dose were both 5 ml , background infusion was 2 ml/h,lockout interval was 5 minute. The NRS score of rest and during movement at 1 ,6 and 24 h after operation,total oxycodone or sufentanil consumption in 24 h, requirement for rescue analgesic, the level of patient′s satisfaction , the adverse events were recorded. Results There was no significant difference in the NRS scores at rest and during movement , total oxycodone or sufentanil consumption in 24 h and postoperative nausea and vomiting （PONV） between the two groups. The patient’s satisfaction were significantly higher （P 〈 0.05）, and the incidence of dizziness were significantly lower （P = 0.026） in group Q than in group S. Both groups were no requirement for rescue analgesic , no sleepiness , no itch , no retention of urine and other adverse reaction. Conclusion PCIA with oxycodone hydrochloride injection is safe and effective in reducing pain after LC operation, however the incidence of dizziness is lower and the level of patient’s satisfaction is higher with oxycodone hydrochloride than with sufentanil.