羟考酮用于经尿道前列腺电切术老年患者喉罩全身麻醉的效果

Effects of oxycodone under laryngeal mask in elderly undergoing transurethral resection of the prostate

目的评价老年患者经尿道前列腺电切术羟考酮诱导效果。方法经尿道前列腺电切术老年患者90例,随机分为芬太尼组、舒芬太尼组、羟考酮组各30例。诱导芬太尼组给予芬太尼1.5μg/kg,舒芬太尼组给予舒芬太尼0.15μg/kg,羟考酮组给予羟考酮0.15 mg/kg,其余药物及方法相同。记录各组入室(T0)、诱导后(T1)、置入喉罩20 s(T2)、手术开始(T3)、手术结束(T4)、拔除喉罩(T5)的平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR),术后苏醒用时、维持药量,苏醒后10 min(T6)、1 h(T7)、2 h(T8)疼痛视觉模拟评分(Visual Analogue Scale,VAS)及不良反应。结果芬太尼组盐酸瑞芬太尼用量比舒芬太尼组和羟考酮组显著增加(P<0.05)。随着时间的延长,3组MAP和HR均呈现波动趋势,芬太尼组MAP和HR在T2时比舒芬太尼组和羟考酮组明显升高(P<0.05),3组MAP和HR时点间差异均有统计学意义(P<0.05)。3组术后VAS评分随着时间而升高,芬太尼组较舒芬太尼组和羟考酮组增高,舒芬太尼组较羟考酮组增高,3组术后VAS评分组间、时点间、组间·时点间差异均有统计学意义(P<0.05)。结论0.15 mg/kg羟考酮有效用于老年患者经尿道前列腺电切术诱导,血流动力学更平稳,术后镇痛优势明显,不良反应未见增加。

Objective To observe the effects oxycodone with laryngeal mask anesthesia in elderly undergoing transurethral resection of the prostate.Methods A total of 90 elderly with transurethral resection of the prostate underwent laryngeal mask general anesthesia were divided into three groups randomly:group fentanyl(group F),group sufentanil(group S),group oxycodone(group O).The induction of group F patients with fentanyl 1.5μg/kg,group S sufentanil 0.15 mg/kg,group O oxycodone 0.15 mg/kg.Drugs of other induction and maintenance were the same.The data of mean arterial pressure(MAP)and heart rate(HR)were recorded at base line T0,induction completed T1,laryngeal mask placed 20 seconds(T2),operation started(T3),operation finished(T4),laryngeal mask pulled out(T5).The recovery time,dosage of drugs for maintenance,the Visual Analogue Score(VAS)and adverse reactions were recorded.Results The dosages of remifentanil in group F were significantly higher than group S and group O(P<0.05).With the time extending,the MAP and HR of three groups all showed fluctuation,the MAP and HR in group F were significantly higher than group S and group O at T2(P<0.05).There were significant differences in MAP and HR among time points of 3 groups(P<0.05).The VAS scores of 3 groups increased with time extending,group F were higher than group S and group O,group S were higher than group O,there were significant differences in VAS scores among groups,time points and groups·time points of 3 groups(P<0.05).Conclusion Oxycodone 0.15 mg/kg was effectively applied to the elderly with transurethral resection of the prostate.It has more stable hemodynamic and an obvious advantage of postoperative analgesia,with no more adwerse reactions.