腹腔镜胆囊切除术后羟考酮与地佐辛镇痛效果比较

Oxycodone versus dezocine for postoperative analgesia in patients following laparascopic cholecystectomy

目的:比较羟考酮与地佐辛用于腹腔镜胆囊切除术(LC)术后镇痛效果。方法:择期全麻下行LC患者60例,均分为两组:羟考酮组(O组,n=30)和地佐辛组(D组,n=30)。手术结束前15 min,两组分别给予羟考酮0.1 mg/kg与地佐辛0.1mg/kg。手术结束前20 min,两组均给予格拉司琼3 mg。记录术后0.5 h(T_1)、1 h(T_2)、2 h(T_3)、4 h(T_4)、8 h(T_5)、24 h(T_6)的疼痛视觉模拟评分(VAS)、镇静评分(Ramsay)及舒适度评分(BCS);当VAS评分>4分时氟比洛芬酯1 mg/kg静脉注射,记录术后24 h内给予氟比洛芬酯例数。观察术后24 h恶心、呕吐等不良反应的发生情况。结果:与D组比较,O组术后T_1、T_2、T_3、T_4、T_5、T_6时刻VAS评分低于D组,BCS评分高于D组;T_1、T_2、T_3时刻Ramsay评分低于D组(P<0.05)。术后24 h内O组恶心、呕吐发生率高于D组(P<0.05)。结论:0.1 mg/kg羟考酮注射液可满足LC术后镇痛,且术后镇痛效果及舒适度优于地佐辛。

Objective：To compare the postoperative analgesia effect in patients undergoing laparascopic cholecystectomy using either oxycodone or dezocine.Methods：Sixty patients undergone elective laparoscopic choleeystectomy under general anesthesia were equally randomized into either oxycodone group （ Group O） or dezoeine group（ Group D） .Granisetron（ 3 mg） was used 20 min before the end of surgery,and 15 min before completion of the operation, patients in the two groups were respectively given oxycodone 0.1 mg/kg and dezocine 0.1 mg/kg. Visual analog scale （VAS） , ramsay sedation score and bruggrmann comfort scale（BCS） were recorded in the two groups at time point of 0.5 h（T1 ） ,1 h（T2） ,2 h（T3） ,4 h（T4） ,8 h（T5） and 24 h（T6） following surgery.Flurbiprofen axetil （ 1 mg/kg） was added in patients with VAS scores being over 4, and cases required flurbiprofen axetil were numbered. Adverse effects associated with the analgesic, including nausea and vomiting, were observed 24 h after operation.Results：Group 0 had lower VAS scores at T1 ,T2 ,T3 ,T4 ,T5 ,T6 ,and Ramsay scores at T1 ,T2 ,T3 ,yet higher BCS scores than group D （P〈0.05） .The incidence of nausea and vomiting 24 h after surgery was higher in group O than group D（P〈0.05） .Conclusion：Oxyeodonc injection in dose of 0.1 mg/kg can lead to better postoperative analgesia than dezocine for patients undergoing laparaseopic cholecysteetomy.