不同剂量羟考酮对男性患者全麻苏醒期导尿管留置反应的治疗作用

Therapeutical effect of different doses of Oxycodone on urethral catheter-related reaction during anesthesia recovery period after general anaesthesia in male adult patients

目的观察不同剂量羟考酮对男性患者全麻苏醒期导尿管留置反应的治疗作用。方法选择2016年6~11月于中国医科大学附属第一医院行择期非泌尿系统手术苏醒期出现导尿管留置不适的男性患者120例,年龄20~60岁,美国麻醉医师协会(ASA)分级Ⅰ~Ⅱ级,采用随机数字表法分为A、B、C、D组,每组各30例。A、B、C组患者分别静脉注射羟考酮0.03、0.05、0.07 mg/kg,所有药物统一稀释至5 mL,D组患者静脉注射5 mL生理盐水。观察四组患者用药前后视觉模拟评分法(VAS)评分、睡眠障碍镇静评分(Ramsay评分)、生命体征变化、导尿管留置反应及不良反应。结果用药后A、B、C组的VAS评分、平均动脉压(MAP)、心率(HR)均低于D组(P<0.05),Ramsay评分高于D组(P<0.05);B、C组患者过度镇静发生率高于A组(P<0.05)。A、B、C组对全麻苏醒期导尿管留置不适治疗效果差异无统计学意义(P>0.05),均优于D组(P<0.05)。四组患者恶心呕吐的发生率差异无统计学意义(P>0.05)。结论静脉注射小剂量(0.03 mg/kg)羟考酮能够治疗男性患者全麻苏醒期尿管留置不适,减轻术后疼痛,有利于血流动力学稳定,而且不增加过度镇静及恶心呕吐的发生。

Objective To observe curative effects of different doses of Oxycodone on urethral catheter-related reaction during anesthesia recovery period after general anaesthesia in male adult patients. Methods 120 male patients underwent elective surgery except urinary system and had urethral catheter-related reaction during anesthesia recovery period from June to November 2016 in the First Hospital Affiliated to China Medical University were enrolled, aged from 20 to 60, the American society of anesthesiologists （ASA） was I - H grade. All the patients were divided into four groups： group A, group B, group C, group D, according to the random number table, with 30 cases in each group. Patients of group A, group B, group C were allocated to receive Oxycodone 0.03, 0.05, 0.07 mg/kg respectively, all drugs were di- luted to 5 mL with saline. Patients of group D were allocated to receive saline 5 mL. Visual analogue scale （VAS） score, Ramsay score, vital signs change, urethral catheter-related reaction before and after treatment, and adverse re- actions were recorded. ResultS After treatment, VAS score, mean arterial pressure （MAP）, heart rate （HR） of group A, group B, group C were lower than those of group D. Ramsay scores of group A, guoup B and grouup C were higher than that of group D, with statistically significant differences （P 〈 0.05）; but the incidence of excessive sedation was signifi- cantly higher in group B and group C than that in group A （P 〈 0.05）. Oxycodone cured urethral catheter-related reac- tion in group A, group B and group C effectively, the curative effects did not differ obviously （P 〉 0.05）, and which were better than that of group D statistically （P 〈 0.05）. No statistical difference in the incidence of nausea and vomit- ing was observed among the fourgroups （P〉 0.05）i Conclusion Intravenous administration of low-dose （0.03 mg/kg） Oxycodone is more suitable for treating urethral catheter-related reaction after general anaesthesia in male adult patients, also can reduce postoperative pain, which is beneficial to the stability of hemodynamics, and does not increase the incidence of excessive sedation, nausea and vomiting.