羟考酮对腹腔镜妇科肿瘤手术全麻苏醒期疼痛的临床效果研究

Clinical effect of oxycodone on pain during recovery from general anesthesia in laparoscopic gynecological tumor surgery

目的评价不同剂量羟考酮缓解腹腔镜妇科肿瘤手术全麻苏醒期疼痛的临床疗效。方法选取2018年2月至2019年2月在陕西省肿瘤医院行腹腔镜妇科肿瘤全麻手术患者84例,采用随机、单盲、对照研究,随机分为A组(n=28)、B组(n=27)和C组(n=29)。手术结束前30 min,A组给予羟考酮0.05 mg/kg,B组给予羟考酮0.1 mg/kg,C组给予羟考酮0.15 mg/kg。比较3组术后3 h的VAS评分情况;记录3组术毕时(T0)、拔管即刻(T1)、拔管后5 min(T2)以及拔管后30 min(T3)的平均动脉压和心率变化;观察3组的苏醒期指标及并发症发生率。结果与A组相比,B、C两组患者术后3 h的VAS评分均降低,差异有统计学意义(P<0.001);B、C两组患者在T1、T2和T3的平均动脉压、心率及Riker镇静-躁动评分均降低,呛咳次数减少,差异有统计学意义(P<0.05);与A、B两组相比,C组患者意识恢复时间和拔管时间延长,差异有统计学意义(P<0.05)。3组患者术后3 h内的并发症发生率比较,差异无统计学意义(P>0.05)。结论手术结束前30 min静脉注射0.1 mg/kg盐酸羟考酮注射液可有效减轻腹腔镜妇科肿瘤手术全麻苏醒期疼痛,缓解苏醒期躁动,维持生命体征平稳,且不影响全麻苏醒,不增加并发症。

Objective To evaluate the clinical efficacy of different doses of oxycodone in relieving pain during the recovery period of general anesthesia during laparoscopic gynecological tumor surgery.Methods A total of 84 patients who underwent laparoscopic gynecological tumor surgery under general anesthesia in Shaanxi provincial cancer hospital from February 2018 to February 2019 were selected and randomly divided into group A(n=28),group B(n=27)and group C(n=29)by a randomized,single-blind,controlled study.30 min before the end of the operation,group A was given 0.05 mg/kg oxycodone,group B was given 0.1 mg/kg oxycodone,and group C was given 0.15 mg/kg oxycodone.The VAS scores of three groups at 3 hours after surgery were compared.The changes of mean arterial pressure and heart rate were recorded at the end of operation(T0),immediately after extubation(T1),5 minutes after extubation(T2)and 30 minutes after extubation(T3)in the three groups.The recovery period indicators and the incidence of complications were observed in the three groups.Results Compared with group A,the VAS scores of group B and C were decreased at 3 h after surgery,and the difference was statistically significant(P<0.001).The mean arterial pressure,heart rate and Riker sedation-agitation scale of patients in group B and C were decreased at T1,T2 and T3,and the number of coughing was decreased.The differences were statistical significance(P<0.05).Compared with group A and B,the recovery time of consciousness and extubation time were longer in group C,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications within 3 h after surgery among 3 groups(P>0.05).Conclusion Intravenous injection of 0.1 mg/kg oxycodone hydrochloride injection 30 min before the end of surgery can effectively reduce the pain during the recovery period of general anesthesia in laparoscopic gynecological tumor surgery,relieve agitation during the recovery period,maintain stable vital signs,and does not affect the recovery of general anesthesia or increase complications.