盐酸羟考酮注射液对腹腔镜胆囊切除术患者术后内脏痛和切口痛的影响

Effect of oxycodone on visceral pain and incision pain of patients underwent laparoscopic cholecystectomy

目的观察盐酸羟考酮注射液对腹腔镜胆囊切除术患者术后内脏痛和切口痛的影响。方法选取解放军总医院第一附属医院择期行腹腔镜胆囊切除术患者60例,随机分为羟考酮组和舒芬太尼组,每组30例。在切皮前羟考酮组患者静脉给予羟考酮注射液0.1 mg·kg^(-1),舒芬太尼组患者静脉给予舒芬太尼注射液0.1μg·kg^(-1)。患者手术结束时均采用罗哌卡因20 m L局部浸润伤口。分别于术后2、4、24 h采用视觉模拟评分法(VAS)评价患者切口痛及内脏痛疼痛程度,记录补救镇痛次数及不良反应发生率。结果 2组患者术后各时间点切口痛VAS评分比较差异均无统计学意义(P>0.05);羟考酮组患者术后2、4 h内脏痛VAS评分显著低于舒芬太尼组(P<0.05),术后24 h2组患者内脏痛VAS评分比较差异无统计学意义(P>0.05)。羟考酮组和舒芬太尼组患者术后24 h内平均补救镇痛次数分别为3.1±0.7和3.5±0.8,2组比较差异无统计学意义(P>0.05)。羟考酮组和舒芬太尼组患者术后不良反应发生率分别为40.0%(12/30)和33.3%(10/30),2组比较差异无统计学意义(P>0.05)。结论盐酸羟考酮可减轻腹腔镜胆囊切除术患者术后内脏痛。

Objective To observe the effect of oxycodone on visceral pain and incision pain of patients underwent laparoscopic cholecystectomy. Methods A total of 60 patients who underwent laparoscopic cholecystectomy in the First Affiliated Hospital of Chinese PLA General Hospital were selected and randomly divided into oxycodone group and sufentanyl group,with30 patients in each group. Before incision,the patients in oxycodone group and sufentanyl group received intravenous injection oxycodone（ 0. 1 mg·kg^-1） and sufentanil（ 0. 1μg·kg^-1） respectively; at the end of surgery,the wound of patients was infiltrated with 20 mL ropivacaine. Visual analogue scale（ VAS） was used to evaluate the visceral pain and incision pain of patients at 2,4 and 24 h after operation; the extra analgesia frequency and incidence of adverse effects were recorded. Results There were no significant differences of VAS scores of incision pain of patients between the two groups at each time point after operation（ P〉0. 05）. The VAS scores of visceral pain of patients in oxycodone group were significantly lower than those in sufentanyl group at 2,4 h after operation; there were no statistic difference of VAS scores of visceral pain of patients between the two groups at 24 h after operation（ P〉0. 05）. The average extra analgesia frequency of patients in oxycodone group and sufentanyl group was 3. 1 ± 0. 7 and 3. 5 ± 0. 8; the incidence of adverse effects of patients in oxycodone group and sufentanyl group was 40. 0%（ 12 /30） and 33. 3%（ 10 /30）; there was no statistic difference of average extra analgesia frequency and incidence of adverse effects of patients between the two groups（ P〉0. 05）. Conclusion Oxycodone can lighten visceral pain in patients who undergoing laparoscopic cholecystectomy.