胃癌根治患者术后应用盐酸羟考酮的镇痛效果观察

Clinical efficacy of oxycodone hydrochloride in treatment with postoperative analgesia in patients with radical gastrectomy

目的:观察胃癌根治切除术患者术后应用盐酸羟考酮的镇痛效果。方法:选取本院2014年4月至2015年6月进行胃癌切除术患者90例作为主要观察对象,术后均进行镇痛泵治疗,采用随机数字表法将患者分为观察组(采用盐酸羟考酮进行止痛,n=45)和对照组(采用舒芬太尼进行止痛,n=45),比较两组患者术后不同时间点镇痛效果(疼痛视觉模拟评分法)、吗啡补充应用剂量、镇静评分变化及不良反应情况。结果:观察组患者在术后2h及术后48h镇痛效果与对照组比较差异无统计学意义;观察组患者在术后6、12、24h镇痛效果均低于对照组(P<0.05);观察组患者术后48h内共2例患者补充应用吗啡肌注(40mg),低于对照组补充用药患者数(9例)和用药总量(150mg),差异有统计学意义(P<0.05)。观察组患者自控按压药物次数低于对照组(P<0.05);观察组患者在术后2h及术后48h镇静评分与对照组比较差异无统计学意义;观察组患者Ramsay镇静评分在术后6、12、24h均高于对照组(P<0.05)。观察组患者术后48h内患者中有2例出现恶心及呕吐,低于对照组的10例(P<0.05)。结论:采用盐酸羟考酮进行胃癌根治切除术患者术后镇痛效果满意,不良反应小,值得临床推广。

Objective：To observe the effect of oxycodone hydrochloride on postoperative analgesic in patients with radical resection of gastric cancer.Methods：Totally 90 cases with gastric cancer resection in hospital April 2014 and 2015 June were selected and divided into observation group （treated with oxycodone hydrochloride for pain） in 45 cases, control group （treated with sufentanil for pain） in 45 cases.The analgesia effect （pain visual analogue score） at different time, morphina supplement dosage, changes of sedation scores and adverse reactions were compared.Results：The patients in the observation group after operation and postoperative analgesic effect of 2 h and 48 h compared with the control group had no significant difference;the patients in the observation group after operation 6 h, 12 h and 24 h analgesic effect was significantly lower than the control group （P〈0.05）;the patients in the observation group after 48 h in patients with a total of 2 cases of application of intramuscular injection of morphine, 40 mg was significantly lower than the control group of patients （9 cases） and the number of the total dosage of 150 mg （P〈0.05）;the number of drug automatic pressing in the observation group was significantly lower than the control group （P〈0.05）;patients in the observation group after the surgery and postoperative 2 h and 48 h score compared with the control group.The Ramsay sedation score in postoperative 6 h, 12 h, 24 h in observation group were significantly higher than control group （P〈0.05）;Two cases in observation group had nausea and vomiting after 48h of operation, which was lower than the control group of 10 cases （P〈0.05）.Conclusions：The oxycodone hydrochloride has satisfied effect on analgesia for gastric cancer radical resection with few adverse effect, which is worth of clinical promotion.