盐酸羟考酮注射液运用于Wilson's病患者脾切除术术后早期疼痛的临床观察

Clinical effect of the oxycodone hydrochloride injection on early pain in patients with Wilson's disease after splenectomy

目的：观察盐酸羟考酮注射液对Wilson＇s病（WD）患者脾切除术术后早期疼痛的效果。方法：WD患者60例随机分为2组：盐酸芬太尼注射液组（F组）和盐酸羟考酮注射液组（O组）。入室后,行常规麻醉诱导、维持。术毕拔管当患者主诉疼痛时,F组立即静脉注射盐酸芬太尼20μg（10μg/m L）,O组立即静脉注射盐酸羟考酮2 mg（1 mg/m L）;必要时间隔5 min给予1 m L,重复给药,直至患者疼痛视觉模拟评分≤4分。麻醉后监测治疗室（PACU）内,记录给药总次数及患者恶心、呕吐发生率;记录患者心率、血压、呼吸频率、血氧饱和度、镇静评分。出PACU后1 h、3 h、6 h,对患者行疼痛视觉模拟评分,询问并记录出PACU后6 h的各项不良反应。出PACU后48 h,询问患者对术后镇痛的满意度,询问并记录出PACU后至首次给予补救药物时间及相关不良反应。结果：PACU内,与F组比较,O组的呼吸频率减慢及血氧饱和度下降的发生率均降低（P〈0.05和P〈0.01）;Ramsay镇静评分O组亦明显低于F组（P〈0.01）。与F组比较,O组滴定给药次数明显减少,补救给药例数明显降低,首次补救镇痛间隔时间明显延长（P〈0.01）。出PACU后6 h,与F组比较,O组呼吸频率减慢和血氧饱和度下降,发生率及镇静评分均降低（P〈0.05~P〈0.01）。出PACU后48 h,与F组比较,O组镇痛满意度增高（P〈0.05）。结论：盐酸羟考酮注射液对WD患者脾切除术术后早期疼痛效果较好且不良反应较少。

Objective： To observe the effects of oxycodone hydrochloride injection on early pain in patients with Wilson＇ s disease（ WD） after splenectomy. Methods： Sixty WD patients were randomly divided into the fentanyl hydrochloride injection group（ group F）and oxycodone hydrochloride injection group（ group O）. In postanesthesia cura unit（ PACU）,the groups F and O were intravenously injected with 20 μg（ 10 μg / m L） of fentanyl and 2 mg（ 1 mg / m L） of oxycodone hydrochloride to relieve pain at extubation after operation,repectively,the treatment did not stop until the VAS score of patients was less than or equal to 4 points,the total number of drug delivery,incidence of nausea and vomiting,and the scores of heart rate,blood pressure,respiratory rate,oxygen saturation and sedation in all patients were recorded. After discharged from PACU,the VAS scores after 1,3 and 6 hours and adverse reactions after 6hours were recorded,the postoperative analgesia satisfactory degree,time of the first administration and adverse reactions after 48 hours in two groups were recorded. Results： In PACU,compared with group F,the incidence of the respiratory rate and blood oxygen desaturation decreasing in group O decreased（ P〈0. 05 and P〈0. 01）,the Ramsay sedation score in group O was lower than that in group F（ P〈0. 01）,the number of titration administration frequency and cases of remedial administration,and the first remedy analgesia interval time in group O significantly decreased and prolonged,respectively（ P〈0. 01）. At 6 h discharged from PACU,compared with group F,the incidence of the respiratory rate slowing and blood oxygen desaturation decreasing and sedation score in group O decreased（ P〈0. 05 and P〈0. 01）. At 48 h discharged from the PACU,compared with group F,the analgesia satisfaction degree in group O increased（ P〈0. 05）. Conclusions： The treatment of the early pain in WD patients after splenectomy with oxycodone hydrochloride injection is good effects and less adverse reactions.