羟考酮治疗腹腔镜胃肠道术后急性疼痛的临床分析

Clinical analysis of oxycodone hydrochloride injection on acute pain management after laparoscopic gastrointestinal surgery

目的观察羟考酮注射液在治疗腹腔镜胃肠道手术后急性疼痛的优势。方法选择行腹腔镜下胃肠道癌根治术患者300例,将300例患者随机分为A组和B组各150例。2组患者均采用瑞芬太尼维持术中镇痛,A组采用羟考酮注射液作术后镇痛,B组采用舒芬太尼作术后镇痛。观察并比较2组患者术后视觉模拟评分法(VAS)评分及Ramsay镇静评分、不良反应等情况。结果 A组术后6h(T2)、术后48h(T5)时点VAS评分小于B组,差异有统计学意义(P<0.05);A组术后1h(T1)、T2时点Ramsay评分小于B组,差异有统计学意义(P<0.05)。A组患者出现烦躁不安、低血压、头晕、嗜睡、呼吸抑制、镇痛不全或镇痛无效等不良反应的发生率低于B组(P<0.05);2组恶心呕吐、瘙痒等发生率比较差异无统计学意义(P>0.05)。结论羟考酮注射液在腹腔镜胃肠道术后有效镇痛有其突出的优势,更接近完美镇痛,有利于患者胃肠道术后快速康复。

Objective To investigate the advantage of oxycodone hydrochloride injection on acute pain management after laparoscopic gastrointestinal surgery. Methods 300 patients who would be treated with laparoscopic radical gastrectomy for gastric cancer,were randomly divided into two groups,each group with 150 cases. Oxycodone hydrochloride injection used after surgery as group A,and sufentanil injection used after surgery as group B. All patients were used remifentanil to ease pain during surgery. Pain VAS score and Ramsay sedation score were evaluated after surgery. In addition,adverse events and side effects were also recorded after surgery. Results At postoperative 6h( T2),48h( T5),the VAS score of group A less than group B,the difference was statistically significant( P < 0. 05); postoperative 1h( T1),T2,the Ramsay score of group A less than group B,the difference was statistically significant( P < 0. 05). Group A of patients with irritability uneasiness,hypotension,dizziness,drowsiness,respiratory depression,incomplete analgesia and analgesia invalid etc. Adverse reaction incidence was lower than that of group B( P < 0. 05); the differences of nausea,vomiting and pruritus occurrence rate between the two groups were not statistically significant( P > 0. 05). Conclusion After laparoscopic gastrointestinal surgery,oxycodone hydrochloride injection has advantage over sufentanil of better pain relief and fewer side effects. It is beneficial to help patients rapid gastrointestinal recovery from post-operation.