羟考酮联合罗哌卡因切口浸润对腹腔镜胆囊切除病人术后转归的影响

Effect of oxycodone combined with incision infiltration with ropivacaine on postoperative outcomes in patients undergoing laparoscopic cholecystectomy

目的评价羟考酮联合罗哌卡因切口浸润对腹腔镜胆囊切除病人术后转归的影响。方法择期全麻下行腹腔镜胆囊切除术病人80例，性别不限，年龄33～64岁，体重45～88 kg，ASA分级Ⅰ或Ⅱ级。采用随机数字表法分为2组（n＝40）：静脉自控镇痛组（P组）和羟考酮联合切口浸润组（O组）。P组胆囊切除后静脉注射芬太尼1～2 μg/kg，术毕行病人自控静脉镇痛，O组静脉注射羟考酮0.05～0.10 mg/kg，0.5%罗哌卡因切口浸润，维持VAS评分≤3分。记录苏醒时间、术后肛门首次排气时间、进流食时间、首次下床活动时间、术后住院时间和不良反应的发生情况。结果与P组比较，O组术后肛门首次排气时间、进流食时间、首次下床活动时间和术后住院时间缩短，尿潴留、恶心呕吐的发生率降低（P〈0.05），苏醒时间差异无统计学意义（P〉0.05）。结论羟考酮联合切口浸润可促进腹腔镜胆囊切除病人术后转归。

Objective To evaluate the effects of oxycodone combined with incision infiltration with ropivacaine on postoperative outcomes in the patients undergoing laparoscopic cholecystectomy.Methods Eighty American Society of Anesthesiologists physical statusⅠorⅡ patients of both sexes, aged 33-64 yr, weighing 45-88 kg, scheduled for elective laparoscopic cholecystectomy under general anesthesia, were divided into 2 groups（n=40 each）using a random number table： patient-controlled intravenous analgesia group（group P）and oxycodone combined with incision infiltration group（group O）. In group P, fentanyl 1-2 μg/kg was intravenously infused after cholecystectomy, and patient-controlled intravenous analgesia was performed with sufentanil at the end of surgery.In group O, oxycodone 0.05-0.10 mg/kg was intravenously injected after cholecystectomy, incision infiltration was performed with 0.5% ropivacaine before suturing, and visual analog scale score was maintained≤3.The emergence time, time to first flatus, time to liquid diet, first ambulation time, length of hospital stay after operation and adverse reactions were recorded.Results Compared with group P, the time to first flatus, time to liquid diet, first ambulation time and length of hospital stay after operation were significantly shortened, the incidence of urinary retention and nausea and vomiting was decreased（P〈0.05）, and no significant change was found in the emergence time in group O（P〉0.05）.Conclusion Combination of oxycodone and incision infiltration with ropivacaine can promote postoperative outcomes in the patients undergoing laparoscopic cholecystectomy.