羟考酮预防全麻患者恢复期导尿管相关膀胱刺激征的适宜剂量探讨

Dose of oxycodone for prevention of catheter related bladder discomfort during recovery from general anesthesia

目的探讨羟考酮预防甲状腺癌根治术全麻患者恢复期导尿管相关膀胱刺激征(catheter related bladder discomfort,CRBD)的适宜剂量。方法选择2015年12月-2017年5月保定市第一中心医院择期行甲状腺癌根治术的男性患者150例,美国麻醉协会(ASA)分级Ⅰ或Ⅱ级,采用随机数字表法分为5组(n=30):对照组(C组)、羟考酮0.03 mg/kg组(O_1组)、羟考酮0.06 mg/kg组(O_2组)、羟考酮0.09 mg/kg组(O_3组)、羟考酮0.12 mg/kg组(O_4组)。手术结束前15 min O_1~O_4组分别静脉注射羟考酮0.03 mg/kg、0.06 mg/kg、0.09 mg/kg、0.12 mg/kg,C组静脉注射15 ml 0.9%氯化钠注射液。观察术后4 h内CRBD及头晕、恶心呕吐、呼吸抑制等不良反应发生情况。结果与C组比较,O_1~O_4组CRBD程度依次降低,其中O_1与O_2、O_3与O_4组组间差异无统计学意义,其他各组间差异均有统计学意义(P均<0.05)。O_4组患者不良反应发生率明显高于其他组(P均<0.05)。结论羟考酮预防全麻恢复期导尿管相关膀胱刺激征的适宜剂量为0.09 mg/kg。

Objective To evaluate the optimum dose of oxycodone for prevention of catheter related bladder discomfort （CRBD） during recovery period from general anesthesia with radical thyroidectomy. Methods One hundred and fifty male patients who underwent radical thyroidectomy in the First Center Hospital of Baoding from December 2015 to May 2017 were included in this study. All the patients were classified as ASA physical status I - ]l , and randomly divided into five groups with 30 in each group： control group （group C）, oxycodone 0.03 mg/kg group （group O1）, oxycodone 0.06 mg/kg group （group 02）, oxycodone 0.09 mg/kg group （group 03） and oxycodone 0.12 mg/kg group （group 04）. At 15 minutes before the end of surgery, oxycodone was intravenously injected at dosage of 0.03 mg/kg, 0.06 mg/kg, 0.09 mg/kg, 0.12 mg/kg in group O1, group 02, group 03 and group 04, respectively. And 15 ml 0.9% NaC1 solution was intravenously injected in group C. The occurrence and severity of CRBD at 4 h after surgery, and the occurrence of dizziness, respiratory depression and nausea and vomiting were observed and recorded. Results Severity of CRBD decreased accordingly in group C, group O1, group 02, group O3 and group 04, and significant differences were found between each two groups （P 〈 0.05） except group O1 vs group 02, and group 03 vs group 04. Compared with group 04, the incidences of dizziness, respiratory depression and nausea and vomiting were significantly lower in group C, group O1, group 02 and group 03 （P 〈 0.05）. Conclusion The optimum dose of oxycodone for prevention of CRBD during recovery from general anesthesia is 0.09 mg/kg.