羟考酮注射液在胃癌根治术术后镇痛的应用

Research on postoperative analgesic effect of oxycodone injection in gastrectomy of stomach neoplasms

目的探讨羟考酮注射液在胃癌根治术患者术后镇痛中的临床疗效。方法选择临床上择期胃癌根治术患者60例分成两组:羟考酮组(O组)和芬太尼组(F组)。O组在术毕前30 min给予羟考酮注射液5 mg,术后羟考酮0.6 mg/kg+昂丹司琼8 mg,生理盐水稀释至100 ml入泵。F组术毕前30 min给予芬太尼0.05 mg,术毕芬太尼16μg/kg+昂丹司琼8 mg,生理盐水稀释至100 ml入泵。记录两组术后2天内0 h、4 h、8 h、12 h、24 h、48 h静息及咳嗽时的疼痛程度并采用VAS评分法评价;记录手术结束后2天内PCA有效按压次数、镇痛药物追加和上腹部不适感等不良反应发生情况。结果与F组相比,术后不同时点O组静息和咳嗽时VAS评分明显降低,术后2天内PCA有效按压次数及镇痛药物追加人数显著下调,上腹不适、皮肤瘙痒、嗜睡、恶心呕吐等不适症状显著改善。结论羟考酮注射液给胃癌根治术患者提供安全有效的镇痛,且不良反应发生较少。

Objective： To observe the effect of oxycodone injection on postoperative analgesia in gastrectomy of stomach neoplasms. Methods： Sixty patients by gastrectomy of stomach neoplasms were randomly divided into two groups,namely oxycodone group（ O Group） and fentanyl group（ F Group）. Patients in O Group were injected oxycodone of 5 mg 30 minutes prior to the operation and oxycodone of 0. 6 mg/kg plus ondansetron of 8mg after the operation,whereas patients in F Group were injected fentanyl of 0. 05 mg 30 minutes prior to the operation and fentanylof 16 μg/kg plus ondansetron of 8 mg after the operation. VAS grades of both groups were recorded at 0,4,8,12,24 and 48 h after operation. Meanwhile,the effective compression times,additional analgesic drugs and side effects,such as abdominal discomfort within 48 hours after operation,were also recorded. Results： Compared with F group,VAS grades of O group at resting and coughing in different times were significantly decreased（ P 0. 05）; the effective compression times and the number of patients with additional analgesic drugs were lowered within 48 hours after operation（ P 0. 05） and the side effects such as abdominal discomfort,nausea and vomiting,drowsiness,pruritus and so on were also lessened（ P 0. 05）. Conclusion： Oxycodone injection offers the efficient and safe analgesia and there is little side effect.