羟考酮注射液联合帕瑞昔布钠治疗瑞芬太尼复合麻醉术后疼痛的疗效观察

EFFICACY OF OXYCODONE INJECTION COMBINED WITH PARECOXIB SODIUM THERAPY FOR POSTOPERATIVE PAIN AFTER REMIFENTANIL COMBINED WITH ANESTHESIA

目的:观察盐酸羟考酮注射液联合帕瑞昔布钠治疗瑞芬太尼全麻后痛觉过敏的疗效及不良反应情况。方法:选择下腹部手术患者60例,随机分为三组:低剂量羟考酮组(Q1)、高剂量羟考酮组(Q2)和羟考酮联合帕瑞昔布钠组(Q+P),每组20例。分别于手术结束前30 min静脉注射羟考酮0.10 mg/kg,羟考酮0.15 mg/kg和羟考酮0.10 mg/kg+帕瑞昔布钠40 mg,观察并记录三组患者停药后苏醒时间、拔管时间、术后疼痛视觉模拟评分(visual analogue scale,VAS)、警觉/镇静评分(alertness/sedation score,OAA/S)、苏醒期躁动(emergence agitation,EA)、药物不良反应(呼吸抑制、恶心呕吐)。结果:三组患者一般资料无统计学差异,Q1组和Q+P组患者的苏醒时间和拔管时间比Q2组短,差异有统计学意义(P<0.05)。Q1组和Q+P组患者OAA/S评分高于Q2组,嗜睡发生率低于Q2组(P<0.05)。在术后疼痛、躁动评分方面Q2组和Q+P组优于Q1组(P<0.05)。结论:手术结束前30 min给予羟考酮注射液联合帕瑞昔布钠可有效的预防瑞芬太尼所引起的痛觉过敏反应,且不良反应少。

Objective: To observe the curative effect and adverse reactions of oxycodone hydrochloride injection combined with parecoxib sodium in the treatment of hyperalgesia after remifentanil anesthesia.Methods: Sixty cases of patients with lower abdominal surgery were randomly divided into three groups (20 cases each group): low dose of oxycodone group (Q1), high dose of oxycodone group (Q2) and oxycodone combined with parecoxib sodium group (Q+P). Thirty minutes before the end of surgery, patients in three group received intravenous oxycodone 0.10 mg/kg, oxycodone 0.15 mg/kg and oxycodone 0.10 mg/kg+parecoxib sodium 40 mg, respectively. The awakening time,extubation time,postoperative pain visual analogue scale(VAS),Alertness/sedation score (OAA/S) , agitation emergence (EA), and adverse drug reactions (respiratory depression, nausea and vomiting) in all patients were observed and recorded. Results: There was no statistical difference of the general information among the three groups. Awakening time and extubation time in group Q1 and group Q+P were shorter than those in group Q2, and the difference was statistically significant (P < 0.05).The OAA/S scores of group Q1 and group Q+P were higher than that of group Q2, while their incidence of drowsiness were lower than that of group Q2 (P < 0.05). Group Q2 and group Q+P were superior to group Q1 in terms of pain and agitation score (P < 0.05). Conclusion: The oxycodone injection combined with parecoxib sodium at 30 min before the end of surgery could effectively prevent remifentanil induced hyperalgesia and induce less adverse reactions.