盐酸羟考酮注射液在脾脏切除术联合断流术后镇痛中的应用

Application of oxycodone hydrochloride injection in postoperative analgesia after splenectomy combined with devasculation

目的:探讨采用盐酸羟考酮注射液对接受脾脏切除术联合断流术的患者进行术后镇痛的可行性和合理性。方法:选取择期在某医院进行脾脏切除术联合断流术的60例患者为研究对象。采用随机数表法将其等分为羟考酮组和芬太尼组。在两组患者手术结束前的30 min,为羟考酮组30例患者静脉注射0.1 mg/kg的盐酸羟考酮注射液,为芬太尼组患者静脉注射1μg/kg的枸橼酸芬太尼。治疗结束后,对比两组患者麻醉清醒后不同时间疼痛的程度、镇静的效果,同时比较其麻醉持续的时间、手术持续的时间、麻醉苏醒的时间、术毕至拔管的时间及术后4 h内不良反应的发生情况。结果:在麻醉清醒后2 h(T 3)~麻醉清醒后(T4),与芬太尼组患者相比,羟考酮组患者NRS的评分较低,P<0.05。在麻醉清醒后5 min(T1)~麻醉清醒后30 min(T2),与芬太尼组患者相比,羟考酮组患者的Ramsay镇静评分较低,P<0.05。与芬太尼组患者相比,羟考酮组患者麻醉苏醒的时间、术毕至拔管的时间均较短,P<0.05。术后4 h内,与芬太尼组患者相比,羟考酮组患者嗜睡、恶心呕吐的发生率均较低,P<0.05。结论:采用盐酸羟考酮注射液对接受脾脏切除术联合断流术的患者进行术后镇痛可取得良好的镇痛及镇静效果,缩短其麻醉苏醒的时间和拔管的时间,且不会增加其嗜睡及恶心呕吐等术后不良反应的发生率。

Objective:To investigate the feasibility and rationality of using oxycodone hydrochloride injection for postoperative analgesia in patients undergoing splenectomy combined with devascularectomy.Methods:60 patients who underwent splenectomy combined with devascularization in a hospital were selected as research objects.They were equally divided into oxycodone group and fentanyl group by random number table method.30 min before the end of surgery,30 patients in the oxycodone group were intravenously injected with 0.1 mg/kg oxycodone hydrochloride injection,and 30 patients in the fentanyl group were intravenously injected with 1μg/kg fentany citrate.After treatment,the degree of pain and sedation effect at different times after anesthesia and wake-up were compared between the two groups.Meanwhile,the duration of anesthesia,operation duration,recovery time from anesthesia,time from operation to extubation and the occurrence of adverse reactions within 4 h after surgery were also compared.RESULTS:From 2 h(T3)to 4 h(T4)after anesthesia,NRS scores of patients in oxycodone group were lower than those in fentanyl group(P<0.05).From 5 min(T1)to 30 min(T2)after anesthesia,Ramsay sedation score of oxycodone group was lower than that of fentanyl group(P<0.05).Compared with fentanyl group,the time of awakening from anesthesia and the time from operation to extubation were shorter in oxycodone group(P<0.05).Within 4 h after surgery,compared with the fentanyl group,the incidence of drowsiness,nausea and vomiting were lower in the oxycodone group(P<0.05).CONCLUSIONS:Oxycodone hydrochloride injection can achieve good analgesic and sedative effects in patients receiving splenectomy combined with devascularization after surgery,shorten the time of anesthesia awakening and extubation,and will not increase t he incidence of postoperative adverse reactions such as drowsiness,nausea and vomiting.