羟考酮在经导管射频消融术治疗心房颤动患者的镇痛研究

Effect of Oxycodone for Analgesia During Radiofrequency Catheter Ablation

目的探讨羟考酮替代舒芬太尼在房颤患者射频消融术中的镇痛作用。方法 100例行房颤射频消融术治疗的患者,随机均分为两组:舒芬太尼组(A组)和羟考酮组(B组)。术前5分钟,A组静脉缓慢注射负荷量舒芬太尼0.1μg/kg,然后静脉泵注舒芬太尼0.1μg/(kg·h);B组静脉缓慢注射负荷量羟考酮0.1 mg/kg,然后静脉泵注羟考酮0.1 mg/(kg·h)。患者疼痛时,A组增加舒芬太尼至0.2μg/(kg·h);B组增加羟考酮至0.2 mg/(kg·h)。观察两组手术持续时间,围术期MAP、HR、RR、SpO2,视觉模拟疼痛评分(VAS)、镇静评分(OAA/S评分),术后患者恶心、呕吐、头晕情况、遗忘情况和满意度。结果 B组术中OAA/S评分高于A组,P<0.05;B组术中呼吸抑制评分高于A组,P<0.05。结论与舒芬太尼比较,羟考酮术中并发症更少,能够安全有效的应用于经导管射频消融术治疗房颤的患者。

Objective To evaluate the efficacy and safety of intravenous oxycodone for analgesia in patients with atrial fibrillation during radiofrequency catheter ablation. Methods Totally 100 patients undergoing radiofrequency ablation for atrial fibrillation were randomly divided into two groups: sufentanil group(group A) and oxycodone group(group B), When group B was given 0.1 mg/kg oxycodone and then intravenous pumped 0.1 mg/(kg·h) oxycodone for pain, group A increased sufentanil to 0.2 g/(kg·h).In group B, oxycodone was increased to 0.2 mg/(kg·h) to observe the operation duration of the two groups, MAP HR RR SpO2 in the perioperative period, visual analogue pain score(VAS) sedation score(OAA/S), postoperative nausea, vomiting, dizziness, amnesia and satisfaction. Results The intraoperative OAA/S score in group B was higher than that in group A(P<0.05).Intraoperative respiratory depression score in group B was higher than that in group A(P<0.05). Conclusion Compared with sufentanil, oxycodone has fewer complications and can be used safely and effectively in patients with atrial fibrillation after transcatheter radiofrequency ablation.