静脉自控镇静泵下盐酸羟考酮在舌颌颈联合根治术患者全麻苏醒中的应用

The application of oxycodone hydrochloride for patients received hyomandibula and neck combined radical surgery during recovery from general anesthesia under PCIA pump

目的:探究盐酸考酮在舌颌颈联合根治术患者全麻醉苏醒中应用。方法:选取在医院拟行舌颌颈联合根治术的60例患者,应用随机数表法将患者分为对照组、观察组A和观察组B,每组20例。对照组术中使用硫酸吗啡0.5 mg/ml;观察组A术中使用盐酸羟考酮0.75 mg/ml;观察组B术中使用硫酸吗啡0.25 mg/ml+盐酸羟考酮0.50 mg/ml。分别计录3组术后2 h、6 h、24 h、48 h和72 h的平均动脉压(MAP),对比3组患者静息状态下的疼痛视觉模拟量表(VAS)评分和Ramsay镇静程度评分及不良反应情况。结果:观察组B在2 h、4 h、24 h和48 h时间点的疼痛VAS评分显著的高于观察组A和对照组,与观察组A比较差异均有统计学意义(t=4.821,t=5.338,t=6.125,t=4.773;P<0.05);与对照组比较差异均有统计学意义(t=5.463,t=5.772,t=5.763,t=4.702;P<0.05)。观察组A在2 h、4 h和24 h时间点的疼痛VAS评分显著高于对照组,两组比较差异有统计学意义(t=4.776,t=4.763,t=4.338;P<0.05)。观察组B在4 h和24 h时间点的MAP显著高于对照组和观察组A,差异有统计学意义(t=5.983,t=5.883,t=6.516,t=5.992;P<0.05)。观察组B与对照组比较在恶心和头疼上差异有统计学意义(x^2=28.125,x^2=47.805;P<0.05)。观察组A与对照组比较在恶心、头晕和头疼上差异有统计学意义(x^2=28.125,x^2=47.805,x^2=47.805;P<0.05)。结论:盐酸羟考酮能够在舌颌颈联合根治术患者全麻醉苏醒过程中镇痛,同时使用0.25 mg/ml硫酸吗啡联合0.50 mg/ml盐酸羟考酮具有良好的镇痛效果,并能够降低患者术后并发症的出现。

Objective:To explore the application of oxycodone hydrochloride for patients received hyomandibula and neck combined radical surgery during recovery from general anesthesia.Methods:60patients who prepared to receive hyomandibula and neck combined radical surgery were divided into control group(n=20cases),observation group A(20cases)and observation group B(20cases).Patients of control were implemented morphine sulfate(0.5mg/mL),and patients of observation group A were implemented oxycodone hydrochloride(0.75mg/mL),and patients of observation group B were implemented the morphine sulfate(0.25mg/mL)combinedwith oxycodone hydrochloride(0.50mg/mL).The mean arterial pressure(MAP)at2h,6h,24h,48h,78h of postoperative patients in three groups were recorded.And visual analog pain score(VAS),Ramsay sedation score and adverse reaction under tranquillization and resting state of the three groups were compared and analyzed.Results:The VAS at2h,4h,24,48h of observation group B were significantly higher than that of observation group A(t=4.821,t=5.338,t=6.125,t=4.773,P<0.05),respectively,and all of them also were significantly higher than that of control group(t=5.463,t=5.772,t=5.763,t=4.702,P<0.05).And the VAS at2h,4h and24h of observation group A were significantly higher than that of control group(t=4.776,t=4.763,t=4.338;P<0.05).On the other hand,the MAP at4h and24h of observation group B were significantly higher than that control group and observation group A(t=5.983,t=5.883,t=6.516,t=5.992;P<0.05),respectively.The differences of nausea and headache between observation group B and control group were statistically significant(x2=28.125,x2=47.805;P<0.05).Besides,the differences of nausea,dizziness and headache between observation group A and control group were statistically significant(x2=28.125,x2=47.805,x2=47.805;P<0.05).Conclusion:Oxycodone hydrochloride has analgesia effect for patients received hyomandibular and neck combined radical surgery during recovery from general anesthesia,and the morphine sulfate(0.25mg/mL)combined with oxycodone hydrochloride(0.50mg/mL)has better analgesia effect,and it can reduce the postoperative complication.