羟考酮在老年经尿道前列腺绿激光汽化术患者喉罩全身麻醉中的应用效果

Application Effect of Oxycodone in Laryngeal Mask General Anesthesia in Elderly Patients Undergoing Transurethral Greenlight Photoselective Vaporization of Prostate

目的:分析羟考酮在老年经尿道前列腺绿激光汽化术(transurethral greenlight photoselective vaporization of prostate,PVP)患者喉罩全身麻醉中的应用效果。方法:选取2021年1月-2022年1月福建中医药大学附属第二人民医院收治的81例老年PVP患者。根据随机数字表法将其分为观察组(41例)和对照组(40例)。两组均给予PVP及喉罩全身麻醉。对照组给予舒芬太尼及其他药物全身麻醉诱导。观察组给予羟考酮及其他药物全身麻醉诱导。比较两组术后即刻、术后2、6 h镇静-躁动程度,麻醉前及术后6 h致痛因子水平,术后2 h内导尿管相关膀胱刺激征(catheter-related bladder discomfort,CRBD)发生情况,术后6 h不良反应。结果:术后2、6 h,两组Ricker镇静-躁动评分(Ricker sedation agitation score,RSAS)均升高,但观察组RSAS低于对照组(P<0.05)。术后6 h,两组血清P物质(substance P,SP)及5-羟色胺(5-HT)水平均升高,但观察组SP、5-HT水平均低于对照组(P<0.05)。术后2 h内,观察组CRBD发生情况优于对照组(P<0.05)。观察组不良反应发生率(31.71%)低于对照组(60.00%)(P<0.05)。结论:羟考酮应用于老年PVP患者喉罩全身麻醉诱导期可抑制致痛因子释放,增强镇痛、镇静作用,缓解CRBD的发生,降低不良反应发生率。

Objective:To analyze the application effect of Oxycodone in laryngeal mask general anesthesia in elderly patients undergoing transurethral greenlight photoselective vaporization of prostate(PVP).Method:From January 2021 to January 2022,81elderly patients undergoing PVP admitted to the Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine were selected.They were divided into observation group(41 cases)and control group(40 cases)according to the method of random number table.Both groups were given PVP and laryngeal mask general anesthesia.The control group was given Sufentanil and other drugs to induce general anesthesia.The observation group was given Oxycodone and other drugs to induce general anesthesia.The degree of sedation agitation immediately after operation,2 and 6 h after operation,pain causing factors before anesthesia and 6 h after operation,the occurrence condition of catheter-related bladder discomfort(CRBD)within 2 h after operation,and adverse reactions 6 h after operation were compared between the two groups.Result:At 2 and 6 h after operation,the Ricker sedation agitation score(RSAS)in both groups increased,but the RSAS in the observation group were lower than those in the control group(P<0.05).At 6 h after operation,the levels of substance P(SP)and 5-hydroxytryptamine(5-HT)in serum of the two groups increased,but SP and 5-HT levels in the observation group were lower than those in the control group(P<0.05).Within 2 h after operation,the occurrence condition of CRBD in the observation group was better than that in the control group(P<0.05).The incidence of adverse reactions in the observation group(31.71%)was lower than that in the control group(60.00%)(P<0.05).Conclusion:Oxycodone applied to elderly PVP patients during induction of general anesthesia with laryngeal mask can inhibit the release of pain causing factors,enhance the analgesic and sedative effects,alleviate the occurrence of CRBD,and reduce the incidence of adverse reactions.