羟考酮联合奥布卡因凝胶对腹腔镜下胆囊切除术男性患者全麻苏醒期的影响

Effects of Oxycodone Combined with Benoxinate gel on the Recovery from General Anaesthesia in Male Adult Patients Undergoing Laparoscopic Cholecystectomy

目的:观察羟考酮联合奥布卡因凝胶对腹腔镜下胆囊切除术男性患者全麻苏醒期的影响。方法:选择2016年6月~12月于中国医科大学附属第一医院行择期全麻腹腔镜下胆囊切除术的男性患者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4组,每组30例,分别为羟考酮组(A组)、奥布卡因凝胶组(B组)、羟考酮联合奥布卡因凝胶组(C组)、对照组(D组)。记录四组患者的苏醒时间、拔管时间,麻醉诱导前(T0)、拔管后即刻(T1)、拔管后15 min(T2)、拔管后30 min(T3)的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO_2)以及T1、T2、T3时的视觉模拟评分法(VAS)评分。同时,记录术后30 min内患者躁动、尿管留置不适的发生情况以及嗜睡、恶心呕吐等不良反应的发生情况。结果:四组患者发热苏醒时间、拔管时间比较差异无统计学意义(P>0.05)。C组患者T1时MAP、HR低于B组和D组(P<0.05),T2、T3时MAP、HR低于A组、B组和D组(P<0.05),各时点的VAS评分低于B组和D组(P<0.05),尿管留置不适发生率低于A组和D组(P<0.05)。四组患者躁动、恶心呕吐、嗜睡等不良反应的发生率比较差异无统计学意义(P>0.05)。结论:羟考酮联合奥布卡因凝胶的使用能够减轻腹腔镜下胆囊切除术男性患者的术后疼痛,减少苏醒期尿管留置不适,有利于血流动力学的稳定,而且不延长苏醒时间和拔管时间,不增加不良反应。

Objective：To observe the effects of oxycodone combined with benoxinate gel on the recovery from general anaesthesia in male adult patients undergoing laparoscopic cholecystectomy.Methods：120 male adult patients scheduled for laparoscopic cholecystectomy from June 2016 to December 2016 in the First Hospital Affiliated to China Medical University were enrolled,aged from 20 to 60,classification of the American society of anesthesiologists （ASA） was [-Ⅱ.All the patients were divided into four groups：oxycodone group （group A）,benoxinate gel group （group B）,oxycodone combined with benoxinate gel group （group C） and control group （group D） according to the random number table,with 30 cases in each group.The recovery time and extubation time were recorded.The levels of mean arterial pressure （MAP）,heart rate（HR） and pulse oxygen saturation（SpO2） at baseline （TO）,immediate time after extubation（T1）,15 min （T2） and 30 min （T3） after extubation were recorded.The visual analogue scale（VAS） score at T1,T2,T3 were recorded.The incidence of agitation,urethral catheter-related reaction,other adverse reactions such as somnolence,nausea or vomiting were recorded within 30 minutes after operation.Results：There was no statistical difference in the recovery time and extubation time among four groups （P＞0.05）.The levels of MAP,HR at T1 in group C were lower than those of group B or group D （P ＜0.05）.The levels of MAP,HR at T2,T3 in group C were lower than other three groups （P ＜0.05）.The VAS scores at T1,T2,T3 in group C were lower than those of group B or group D （P ＜0.05）.The occurrence rate of urethral catheter-related reaction in group C was lower than those of group A or group D （P ＜0.05）.No statistical difference was found in the incidence of agitation,nausea or vomiting among four groups （P＞0.05）.Conclusions：Oxycodone combined with benoxinate gel could relieve the postoperative pain,reduce the urethral catheter-related reaction in male adult patients umdergoing laparoscopic cholecystectomy.It was also beneficial to the stability of hemodynamics and wouldn＇t prolong the extubation time and emergence time or increase the other adverse reactions.