不同剂量羟考酮用于眼科手术患者全身麻醉的效果比较

Efficacy of different doses of oxycodone for general anesthesia in patients undergoing ophthalmology surgery

目的比较不同剂量羟考酮用于行眼科手术患者全身麻醉的效果。方法60例患者择期全麻下行眼科手术,年龄50~70岁,ASAⅠ或Ⅱ级,随机分为羟考酮0.1 mg/kg(O1)组和羟考酮0.2 mg/kg(O2)组。记录两组患者全麻诱导、手术和复苏期间的血流动力学变化情况,复苏室内呼吸恢复、拔除喉罩和出复苏室时间,及出复苏室时Ramsay镇静评分和拔除喉罩后及术后4 h的疼痛数字评分量表(numeric rating scale,NRS)评分,同时记录手术后24 h内发生的低氧、恶心、呕吐等不良反应情况。结果O1组麻醉诱导期低血压发生率明显低于O2组,围术期血管活性药物的用量明显少于O2组(P<0.05)。比较两组患者的呼吸恢复、拔除喉罩、出室时间,O1组均明显短于O2组(P<0.05)。O1组患者拔除喉罩后低氧发生率及出复苏室时Ramsay镇静评分均明显低于O2组(P<0.05)。结论0.1 mg/kg羟考酮用于眼科手术患者全身麻醉,能够提供有效的镇痛,且诱导期血流动力学更为平稳,苏醒迅速,拔除喉罩后低氧发生率更低。

Objective To compare the efficacy of different doses of oxycodone for general anesthesia in patients undergoing ophthalmic surgery. Methods Sixty patients(aged 50-70 years,ASA Ⅰ or Ⅱgrade)scheduled for ophthalmology surgery were randomly divided into 0.1 mg/kg oxycodone(O1)group and 0.2 mg/kg oxycodone(O2) group. Patient demographics,surgical time and anesthesia time,perioperative hemodynamic parameters and requirement of vasoactive medication,postoperative pain and requirement of rescue analgesics,postoperative sedation level and recovery time,and perioperative complications were recorded. Results Patients in group O1 experienced less clinically significant hypotension compared to group O2. Consistently,patients in group O1 required less intraoperative vasoactive medication(ephedrine)than those in group O2.The recovery time was longer and sedation level was higher in group O2 than group O1. The incidence of hypoxia during postoperative recovery was higher in group O2 than group O1. Conclusion Oxycodone of 0.1 mg/kg can be a safe and effective application for patients undergoing general anesthesia for ophthalmic surgeries,with adequate pain control,more stable hemodynamic parameters during induction phrase,quicker recovery and less incidence of hypoxia.