不同时间点注射羟考酮对腹腔镜结肠癌术后镇痛效果分析

Effects of oxycodone injected at different time points in analgesia after laparoscope radical resection of colorectal cancer

目的探讨不同时间点注射羟考酮对腹腔镜结肠癌根治术后镇痛的效果。方法选择腹腔镜结肠癌根治术患者84例,根据入院先后顺序,分为A组(切皮前10 min静脉注射0.1 mg/kg羟考酮,27例)、B组(缝皮前10 min静脉注射0.1 mg/kg羟考酮,29例)、C组(拔管后静脉注射0.1 mg/kg羟考酮,28例),比较3组术后1 h(T1)、4 h(T2)、8 h(T3)、12 h(T4)、24 h(T5)各时间点的疼痛VAS评分、镇静Ramsay评分、舒适度BCS评分及不良反应。结果 C组T1、T2时的VAS评分均明显高于A、B组,B组T3时VAS评分均明显低于A、C组(P<0.05);A、C组T3时VAS评分比较无统计学差异(P>0.05);T4、T5时3组间VAS评分比较无统计学差异(P>0.05)。T1、T2时A、B组的Ramsay和BCS评分明显高于C组(P<0.05),T3~T5时3组间Ramsay和BCS评分比较无统计学差异(P>0.05)。3组不良反应发生率无统计学差异(P>0.05)。结论对于腹腔镜结肠癌根治术患者,缝皮前10 min静脉注射0.1 mg/kg羟考酮,是较优的减轻术后疼痛给药时间点。

Objective To explore the effects of oxycodone injected at different time points in analgesia after laparoscope radical resection of coloreetal cancer. Methods A total of 84 patients to receive laparoseope radical resection of coloreetal cancer were selected and divided into group A （to receive intravenous injection of 0.1 mg/kg oxyeodone 10 minutes before skin incision, n=27）, group B （to receive intravenous injection of 0.1 mg/kg oxyeodone 10 minutes before skin closure, n=29） and group C （to receive intravenous injection of 0.1 mg/kg oxyeodone after extubation, n=28） according to the sequence of admission. The pain VAS scores, calm Ramsay scores, comfort BCS scores and adverse reactions one hour （T1）, four hours （T2）, eight hours （T3）, 12 hours （T4） and 24 hours （T5） after the operation among the three groups were compared, Results The VAS scores at T1 and T2 in group C were significantly higher than those in groups A and B, while the VAS scores at T3 in group B were much lower than those in groups A and C （P 〈 0.05）; the VAS scores at T3 between groups A and C showed no statistical difference （P 〉 0.05）, and the VAS scores at T4 and T5 among the three groups showed no statistical differenee（P 〉 0.05）. The Ramsay and BCS scores at T1 and T2 between groups A and B were much higher than those in group C （P 〈 0.05）, while the Ramsay and BCS scores at T3-T5 among the three groups showed no statistical difference （P 〉 0.05）. There was no statistical difference in the incidence of adverse reactions among the three groups （P 〉 0.05）. Conclusion For the patients to receive caparoscope radical resection of colorectal cancer, 10 minutes betore skin closure is an optimal time point of administration of 0.1 mg/kg oxycodone by intravenous injection to relieve postoperative pain.