Trends in oxycodone and oxycodone-containing analgesics administration for back pain in emergency departments in the USA(2007–2018)

BACKGROUND:To describe trends in oxycodone and oxycodone-containing analgesic prescribing for the treatment of back pain among adults in emergency departments(EDs) in the USA from 2007 to 2018.METHODS:Data were gathered from the National Hospital Ambulatory Medical Care Survey(NHAMCS) from 2007 to 2018.The study population included individuals of all ages presenting to USA EDs.The NHAMCS reasons for visit and oxycodone drug ID codes were used to isolate patients with back pain.The main outcome was the proportion of oxycodone and oxycodone-containing analgesics prescribed for back pain in the EDs over the specified time period.RESULTS:There was a relative decrease in the overall administration of oxycodone for back pain in the EDs by 62.3% from 2007(244,000 visits) to 2018(92,000 visits).The proportion of ED patients prescribed with oxycodone-containing analgesics for back pain increased among patients aged 45 years and older(from 43.8% to 57.6%),female patients(from 54.5% to 62.0%),black patients(from 22.5% to 30.4%),and Hispanic/Latino patients(from 9.4% to 19.6%).Oxycodone/acetaminophen was most prescribed and accounted for 90.2% of all oxycodone-containing analgesics in 2007,with a decrease to 68.5% in 2018.Pure oxycodone was the second most prescribed medication,accounting for 6.1% in 2007 and 31.5% in 2018.CONCLUSION:The overall number of oxycodone-containing analgesics decreased significantly from 2007 to 2018.However,that number trended upward in 45-year-old and older,female,black,or Hispanic/Latino patients from 2007 to 2018.The total amount of pure oxycodone increased significantly from 2007 to 2008.

Simultaneous determination of acetaminophen and oxycodone in human plasma by LC–MS/MS and its application to a pharmacokinetic study

A simple and rapid liquid chromatography-tandem mass spectrometry （LC-MS/MS） method was de- veloped and validated for simultaneous determination of acetaminophen and oxycodone in human plasma. Acetaminophen-d4 and oxycodone-d3 were used as internal standards. The challenge en- countered in the method development that the high plasma concentration level of acetaminophen made the MS response saturated while the desired lower limit of quantification （LLOQ,） for oxycodone was hard to reach was well solved. The analytes were extracted by protein precipitation using acetonitrile. The matrix effect of the analytes was avoided by chromatographic separation using a hydrophilic C18 column coupled with gradient elution. Multiple reaction monitoring in positive ion mode was performed on tandem mass spectrometer employing electrospray ion source. The calibration curves were linear over the concentration ranges of 40.0-8000 ng/mL and 0.200-40.0 ng/mL for acetaminophen and oxycodone, respectively. This method, which could contribute to high throughput analysis and better clinical drug monitoring, was successfully applied to a pharmacokinetic study in healthy Chinese volunteers.

Acetaminophen overdose-induced acute liver injury can be alleviated by static magnetic field

Acetaminophen(APAP),the most frequently used mild analgesic and antipyretic drug worldwide,is implicated in causing 46%of all acute liver failures in the USA and between 40%and 70%in Europe.The predominant pharmacological intervention approved for mitigating such overdose is the antioxidant N-acetylcysteine(NAC);however,its efficacy is limited in cases of advanced liver injury or when administered at a late stage.In the current study,we discovered that treatment with a moderate intensity static magnetic field(SMF)notably reduced the mortality rate in mice subjected to high-dose APAP from 40%to 0%,proving effective at both the initial liver injury stage and the subsequent recovery stage.During the early phase of liver injury,SMF markedly reduced APAPinduced oxidative stress,free radicals,and liver damage,resulting in a reduction in multiple oxidative stress markers and an increase in the antioxidant glutathione(GSH).During the later stage of liver recovery,application of vertically downward SMF increased DNA synthesis and hepatocyte proliferation.Moreover,the combination of NAC and SMF significantly mitigated liver damage induced by high-dose APAP and increased liver recovery,even 24 h post overdose,when the effectiveness of NAC alone substantially declines.Overall,this study provides a noninvasive non-pharmaceutical tool that offers dual benefits in the injury and repair stages following APAP overdose.Of note,this tool can work as an alternative to or in combination with NAC to prevent or minimize liver damage induced by APAP,and potentially other toxic overdoses.

Efficacy and safety of controlled-release oxycodone/naloxone versus controlled-release oxycodone in Korean patients with cancer-related pain: a randomized controlled trial

Background: Controlled-release oxycodone/naloxone(OXN-CR) maintains the effect of opioid-induced analgesia through oxycodone while reducing the occurrence rate of opioid-induced constipation through naloxone. The present study was designed to assess the non-inferiority of OXN-CR to controlled-release oxycodone(OX-CR) for the control of cancer-related pain in Korean patients.Methods: In this randomized, open-labeled, parallel-group, phase IV study, we enrolled patients aged 20 years or older with moderate to severe cancer-related pain [numeric rating scale(NRS) pain score ≥4] from seven Korean oncology/hematology centers. Patients in the intention-to-treat(ITT) population were randomized(1:1) to OXNCR or OX-CR groups. OXN-CR was administered starting at 20 mg/10 mg per day and up-titrated to a maximum of80 mg/40 mg per day for 4 weeks, and OX-CR was administered starting at 20 mg/day and up-titrated to a maximum of 80 mg/day for 4 weeks.The primary efficacy endpoint was the change in NRS pain score from baseline to week4, with non-inferiority margin of-1.5. Secondary endpoints included analgesic rescue medication intake, patientreported change in bowel habits, laxative intake, quality of life(QoL), and safety assessments.Results: Of the ITT population comprising 128 patients, 7 with missing primary efficacy data and 4 who violated the eligibility criteria were excluded from the efficacy analysis. At week 4, the mean change in NRS pain scores was not significantly different between the OXN-CR group(n = 58) and the OX-CR group(n = 59)(-1.586 vs.-1.559,P = 0.948). The lower limit of the one-sided 95% confidence interval(-0.776 to 0.830) for the difference exceeded the non-inferiority margin(P < 0.001). The OXN-CR and OX-CR groups did not differ significantly in terms of analgesic rescue medication intake, change in bowel habits, laxative intake, QoL, and safety assessments.Conclusions: OXN-CR was non-inferior to OX-CR in terms of pain reduction after 4 weeks of treatment and had a similar safety profile. Studies in larger populations of Korean patients with cancer-related pain are needed to further investigate the effectiveness of OXN-CR for long-term pain control and constipation alleviation.Trial registration ClinicalTrials.gov NCT01313780, registered March 8。

Advances in the clinical application of oxycodone in the perioperative period

To review the research progress of pure opioid receptor agonist oxycodone.The research progress of oxycodone in terms of pharmacokinetics,pharmacodynamics,adverse reactions,clinical application,combined medication and new progress in clinical application was summarized by referring to the literature.Oxycodone is a semi-synthetic thebaine derivative of opioid alkaloids,and is a pure opioidμandκreceptor agonist.The main action sites are the central nervous system and visceral smooth muscle.Due to its advantages of low adverse reactions,good analgesic effects,and a wide range of safe doses,the drug has been widely used in the control of acute and chronic postoperative pain,as well as malignant and non-malignant pain.Since the end of the 20^(th) century,researchers have begun to formulate antipyretic analgesics,opioid receptor agonists,opioid receptor antagonists,dopamine receptor antagonists and other drugs with oxycodone in different proportions to enhance the analgesic effect.At the same time,it can reduce the dosage of oxycodone and reduce its adverse reactions,so as to achieve the purpose of limiting opioid abuse.With the continuous research on the efficacy and safety of oxycodone in the perioperative period at home and abroad,oxycodone has become the only dual-opioid potent analgesic that can be used in clinical work.

Effect of dexmedetomidine combined with oxycodone on systemic stress response in recovery of gynecological laparoscopic operation

Objective:To study the effect of dexmedetomidine combined with oxycodone on systemic stress response in recovery period of gynecological laparoscopic operation.Methods:A total of 86 patients who received laparoscopic operation in the Second Affiliated Hospital of Kunming Medical University between June 2014 and December 2016 were selected and randomly divided into the dexmedetomidine combined with oxycodone group (DO group) and control group (C group). Before anesthesia induction (T1), at the end of the surgery and before micro pump injection of dexmedetomidine and oxycodone hydrochloride (T2) and in recovery period (T3), serum levels of pituitary-target gland axis-related hormones, vascular activity-related hormones and oxidative stress-related molecules were determined.Results: At T1 and T2, serum TSH, T3, T4, ACTH, Cor, NE, E, ADH, AT-II, ROS, MDA, SOD and HO-1 levels of DO group were not significantly different from those of C group;at T3, serum TSH, T3, T4, ACTH, Cor, NE, E, ADH, AT-II, ROS and MDA levels of DO group were significantly lower than those of C group while SOD and HO-1 levels were significantly higher than those of C group.Conclusions: Dexmedetomidine combined with oxycodone can inhibit the systemic stress response in recovery of gynecological laparoscopic operation.

Comparison of the Efficacy of Oral Oxycodone and Oral Codeine in the Treatment of Post-Craniotomy Pain—A Randomized, Double-Blind Trial

Background: Post-craniotomy pain has been reported to be moderate to severe. Management of post-craniotomy pain is often inadequate, yet limited by the side effects of opioids. We aim to find out the efficacy of oral oxycodone as compared to oral codeine for the treatment of post-craniotomy pain in our institution. Methods: A randomized, double-blinded controlled trial was used to evaluate the efficacy of oral oxycodone versus oral codeine. 40 patients were randomized to the control group of codeine (n = 20) or the experimental group receiving oxycodone (n = 20) in addition to regular oral paracetamol for both groups of patients. Results: There was no difference in the visual analogue scale scores at 24 hours (2.78 versus 1.85, p = 0.11) or side effects in the oxycodone group compared with the codeine group. Conclusions: Oral oxycodone had similar efficacy as oral codeine in the management of post-craniotomy pain.

Acura制药公司oxycodone口服速释片

羟二氢可待因酮（0xycodone）片剂——OxyADF2期临床试验显示该制剂具有潜在的戒瘾作用。

Development of controlled release bi-layered tablets containing oxycodone hydrochloride

Oxycodone hydrochloride is a semi-synthetic opioid agonist that provides very effective relief for moderate to severe pain in cancer and post-operative patients. Controlled release oxycodone formulations have been studied to enhance the therapeutic effect by providing constant release over the whole dosing interval and improve patient’s convenience by reducing the frequency of administration as well.

Comparison of Efficacy and Safety of Oxycodone Versus Fentanyl for Intravenous Patient-Controlled Analgesia in Postoperative Pain Management:A Systematic Review and Meta-Analysis

Backgroud:Intravenous opioid patient-controlled analgesia(IV-PCA)has been suggested as an effective method in postoperative pain management.There are several randomized controlled trials(RCTs)of comparison of oxycodone and fentanyl for IV-PCA in surgical patients.The purpose of this study was to perform a meta-analysis to compare the efficacy and safety of oxycodone and fentanyl for IV-PCA in surgical patients from current data.Methods:The RCTs of oxycodone versus fentanyl for IV-PCA were gathered from PubMed,Embase,Cochrane library,CNKI and VIP data.After data extraction and quality assessment of the included RCTs,the RevMan 5.3 software was applied for meta-analysis of numerical rating scale(NRS)scores,accumulated IV-PCA consumption of oxycodone and fentanyl,patient satisfaction,postoperative nausea and vomiting(PONV),and other adverse events(AEs).Results:Results reported from eight RCTs involving 600 patients are included in the meta-analysis.The NRS score at rest and upon movement of group oxycodone was significantly lower than that of group fentanyl(WMD=-3.85,95%CI-4.93^-2.76,P<0.00001;WMD=-4.31,95%CI-5.79^-2.84,P<0.00001);however,the incidence of PONV and dizziness was obviously increased in group oxycodone than in group fentanyl(OR=2.41,95%CI 1.60~3.63,P<0.0001;OR=3.69,95%CI 2.17~6.26,P<0.00001).Accumulated IV-PCA consumption in group oxycodone was less than in group fentanyl overall the 48 hours postoperatively(WMD=-12.11,95%CI-18.42^-5.80,P=0.0002).There was no significant difference in patient satisfaction between oxycodone and fentanyl(OR=0.73,95%CI 0.11~5.04,P=0.75).Conclusion:According to the evidence,this meta-analysis suggest that oxycodone for IV-PCA is superior to fentanyl in postoperative pain relief,whereas the higher incidence of PONV and dizziness was accompanied with oxycodone.Further large-scale,prospective,observational studies are needed to summarize and analyse the data to draw a fair conclusion.

Effects of oxycodone and fentanyl patient-controlled intravenous analgesia on pain, immune response and stress response after laparoscopic surgery

Objective:To study the effects of oxycodone and fentanyl patient-controlled intravenous analgesia on pain, immune response and stress response after laparoscopic surgery.Methods:Patients undergoing laparoscopic surgery in Xianning Central Hospital between June 2015 and February 2017 were selected and randomly divided into oxycodone group and fentanyl group who received postoperative oxycodone and fentanyl patient-controlled intravenous analgesia respectively. 3 d after surgery and 5 d after surgery, the serum contents of pain-related transmitters, immune indexes, stress-related molecules as well as peripheral blood contents of immune cells were measured.Results: 3 d after surgery and 5 d after surgery, CRP, TNF-α, IL-8, sICAM-1, YKL-40, Cor, C-P, FT3, FT4 and HO-1 contents in serum of oxycodone group were significantly lower than those of fentanyl group whereas CD3+CD4+T cell and CD3+CD8+T cell contents in peripheral blood as well as C3 and C4 contents in serum were significantly higher than those of fentanyl group.Conclusion:oxycodone patient-controlled intravenous analgesia after laparoscopic surgery is better than fentanyl and can reduce the pain degree, inhibit the stress response and improve the immune response.

Analgesic effect of oxycodone combined with parecoxib sodium after laparoscopic cholecystectomy and its influence on inflammatory stress response

Objective: To discuss the analgesic effect of oxycodone combined with parecoxib sodium after laparoscopic cholecystectomy and its influence on inflammatory stress response. Methods:A total of 260 patients with chronic cholecystitis who accepted laparoscopic cholecystectomy in this hospital between December 2016 and May 2017 were divided into control group (n=130) and oxycodone group (n=130) by random number table method. Control group received morphine combined with parecoxib sodium analgesia after operation, and oxycodone group received oxycodone combined with parecoxib sodium analgesia after operation. The differences in serum levels of pain mediators, inflammatory mediators and stress hormones were compared between the two groups immediately after operation (T0), 12 h after operation (T1) and 24 h after operation (T3). Results: At T0, there was no statistically significant difference in serum levels of pain mediators, inflammatory mediators and stress hormones between the two groups. At T1 and T2, serum pain mediators PGE2, NPY, SP and NGF levels of oxycodone group were lower than those of control group whereas β-EP levels were higher than those of control group;serum inflammatory mediators CRP, IL-1β, IL-6 and TNF-αlevels were lower than those of control group;serum stress hormones Cor, NE and INS levels were lower than those of control group. Conclusion: Oxycodone combined with parecoxib sodium analgesia after laparoscopic cholecystectomy can effectively relieve the pain perception and inhibit the systemic inflammatory response and stress response.

Effect of oxycodone hydrochloride injection preemptive analgesia on serum inflammatory factors, neurotransmitter index and immune function in patients with laparoscopic cholecystectomy

Objective:To investigate the effect of oxycodone hydrochloride injection preemptive analgesia on serum inflammatory factors, neurotransmitter index and immune function in patients with laparoscopic cholecystectomy.Methods: According to random data table, 113 patients undergoing laparoscopic cholecystectomy were divided into control group (n=57) and observation group (n=56), patients in the control group were treated with sufentanil citrate injection analgesia, and the observation group patients were given oxycodone hydrochloride injection analgesia, level of serum inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6)], neurotransmitter index [5-hydroxy tryptamine (5-HT), P substance] and immune function index [CD4+, CD8+, CD4+/CD8+] of two groups between preoperative and postoperative 1d were compared.Results: There were no significant difference in level of TNF-α, IL-6, 5-HT, P substance, CD4+, CD8+ and CD4+/CD8+ between the two groups preoperative. Compared with the level of the same group preoperative, at postoperative 1 d level of TNF-α, IL-6, 5-HT, P substance, CD8+were significantly increased, moreover level in the observation group were significantly lower compared with the control group, the difference was statistically significant;Postoperative 1 d, level of CD4+, CD4+/CD8+ in the two groups were significantly lower than the preoperative level within the group, and the observation group was significantly higher than the control group.Conclusion: Oxycodone hydrochloride injection preemptive analgesia in laparoscopic cholecystectomy can effectively reduce serum inflammatory factors and neurotransmitter index release, improve immune function, has an important clinical value.

Glutaredoxin-1 alleviates acetaminophen-induced liver injury by decreasing its toxic metabolites

Excessive N-acetyl-p-benzoquinone imine(NAPQI)formation is a starting event that triggers oxidative stress and subsequent hepatocyte necrosis in acetaminophen(APAP)overdose caused acute liver failure(ALF).S-glutathionylation is a reversible redox post-translational modification and a prospective mechanism of APAP hepatotoxicity.Glutaredoxin-1(Glrx1),a glutathione-specific thioltransferase,is a primary enzyme to catalyze deglutathionylation.The objective of this study was to explored whether and how Glrx1 is associated with the development of ALF induced by APAP.The Glrx1 knockout mice(Glrx1^(-/-))and liver-specific overexpression of Glrx1(AAV8-Glrx1)mice were produced and underwent APAPinduced ALF.Pirfenidone(PFD),a potential inducer of Glrx1,was administrated preceding APAP to assess its protective effects.Our results revealed that the hepatic total protein S-glutathionylation(PSSG)increased and the Glrx1 level reduced in mice after APAP toxicity.Glrx1^(-/-)mice were more sensitive to APAP overdose,with higher oxidative stress and more toxic metabolites of APAP.This was attributed to Glrx1 deficiency increasing the total hepatic PSSG and the S-glutathionylation of cytochrome p4503a11(Cyp3a11),which likely increased the activity of Cyp3a11.Conversely,AAV8-Glrx1 mice were defended against liver damage caused by APAP overdose by inhibiting the S-glutathionylation and activity of Cyp3a11,which reduced the toxic metabolites of APAP and oxidative stress.PFD precede administration upregulated Glrx1 expression and alleviated APAP-induced ALF by decreasing oxidative stress.We have identified the function of Glrx1 mediated PSSG in liver injury caused by APAP overdose.Increasing Glrx1 expression may be investigated for the medical treatment of APAP-caused hepatic injury.

对乙酰氨基酚联合酮咯酸氨丁三醇对腹腔镜胆囊切除术后镇痛的影响

目的探讨对乙酰氨基酚联合酮咯酸氨丁三醇在腹腔镜胆囊切除术(LC)患者术后早期疼痛管理中的有效性及安全性。方法选择择期在全麻下行LC患者90例,男42例,女48例,年龄18~78岁,BMI 18~28 kg/m^(2),ASAⅠ或Ⅱ级。采用随机数字表法分为两组:对乙酰氨基酚联合酮咯酸氨丁三醇组(AK组)和纳布啡组(NA组),每组45例。麻醉诱导前15 min,AK组静脉泵注对乙酰氨基酚500 mg(稀释至50 ml)后缓慢推注酮咯酸氨丁三醇30 mg(稀释至10 ml);NA组于相同时点静脉泵注生理盐水50 ml后缓慢推注纳布啡0.2 mg/kg(稀释至10 ml)。记录术后0.5、3、6、12、24 h的VAS疼痛评分(非劣效性界值Δ=1.0分),手术当晚睡眠质量评分,术后24 h内补救镇痛例数,术后0.5、3、6 h的Ramsay镇静评分,术后24 h内恶心呕吐等不良反应的发生情况,以及患者总体满意度。结果与NA组比较,术后0.5 h AK组VAS疼痛评分明显降低(P<0.05),且两组VAS疼痛评分差值的95%CI上限低于非劣效性界值(P<0.05)。AK组手术当晚睡眠质量评分、患者总体满意度明显高于NA组(P<0.05)。两组术后24 h内补救镇痛率、不同时点Ramsay镇静评分、术后24 h内恶心呕吐发生率差异无统计学意义。结论对乙酰氨基酚联合酮咯酸氨丁三醇可有效改善腹腔镜胆囊切除术后早期疼痛,不增加恶心呕吐发生率,效果不劣于纳布啡,且患者术后当晚睡眠质量评分和总体满意度更高。

艾司奥美拉唑对对乙酰氨基酚药动学与肠道菌群的影响

目的探讨质子泵抑制剂(PPI)艾司奥美拉唑(EMZ)对对乙酰氨基酚(APAP)药动学与肠道菌群生态平衡的作用。方法将14只SD大鼠随机分为2组,分别为APAP组、APAP+EMZ组,每组7只;将APAP+EMZ组大鼠置于代谢笼中饲养。APAP+EMZ组灌胃给予EMZ 3.6 mg·kg^(-1)·d^(-1),APAP组以等体积0.9%氯化钠溶液代替,连续灌胃14 d;分别在给予EMZ前和给药14 d后收集大鼠粪便进行微生物16SrRNA测序。第15天APAP组和APAP+EMZ组灌胃EMZ后同法给予APAP 44.82 mg·kg^(-1)。超高效液相色谱-串联质谱(UPLC-MS/MS)法测定样品中APAP浓度。计算药动学参数并统计分析,比较APAP组和APAP+EMZ组APAP药动学参数。结果①两组APAP的达峰浓度(C max)比较差异有统计学意义(P<0.05),与APAP组比较,APAP+EMZ组C max增加120.38%。两组血药浓度-时间曲线下面积(AUC_((0-∞)))、清除率(CL)、消除半衰期(t_(1/2))和达峰时间(t_(max))比较均差异无统计学意义(均P>0.05);②使用EMZ后乳酸杆菌属、拟杆菌属、梭状芽孢杆菌属和埃希杆菌属相对丰度较用药前减少,而双歧杆菌属增加。但上述菌群相对丰度在EMZ干预前后差异无统计学意义(P>0.05)。结论EMZ与APAP联用时,影响β-葡萄糖醛酸苷酶的菌群相对丰度有一些变化,EMZ对APAP的C_(max)有影响;使用EMZ 2周不通过影响肠道菌群而改变APAP的药动学。

羟考酮超前镇痛方案有效性与安全性的系统评价与Meta分析

目的通过系统综述和Meta分析评价羟考酮超前镇痛方案对手术患者的有效性与安全性。方法计算机检索英文数据库(PubMed,Medline,Web of Science,Embase,Cochrane图书馆)及中文数据库[中国学术期刊全文数据库(CNKI)、中国生物医学文献数据光盘数据库(CBM disc)及维普数据库(VIP)]纳入涉及羟考酮超前镇痛相关的各类型研究。文献检索时间为数据库建立至2023年6月30日。评价指标包括:术后患者疼痛视觉评分(VIS),术后并发症发生率。用RevMan 5.4和SPSS 23.0软件进行统计学分析。结果检出文献13810篇,根据纳入标准最终入选15篇文献进行系统评价,10项RCT研究进入Meta分析;共入选病例890例。与对照组(生理盐水或安慰剂)患者相比,羟考酮超前镇痛组患者术后8 h/12 h疼痛VIS评分(IV=-1.00,95%CI:-1.21~-0.78,P<0.001)、术后4 h/6 h疼痛VIS评分(IV=-1.06,95%CI:-1.50~-0.62,P<0.001)、术后24 h疼痛VIS评分(IV=-0.53,95%CI:-0.86~-0.20,P=0.002)存在显著差异,羟考酮超前镇痛组患者疼痛评分更低;两组患者术后不良反应发生率(OR=0.34,95%CI:0.17~0.7,P=0.003)存在显著差异,羟考酮超前镇痛组患者术后不良反应发生率更低,差异均有统计学意义(P<0.05)。结论羟考酮超前镇痛方案可以广泛应用于外科手术的麻醉实践中,其有效性和安全性得到验证。具有术后患者疼痛更轻,不良反应发生更少的优势。

全身麻醉下胸横肌平面-胸神经阻滞在乳腺癌手术患者中的价值

目的:评价胸横肌平面-胸神经(transversus thoracic muscle plane-pectoral nerves,TTP-PECS)阻滞用于减阿片类药物全麻下乳腺癌改良根治术中的安全性与可行性。方法:选择择期行乳腺癌改良根治术的患者60例,随机分为TTP-PECS阻滞联合减阿片药物全麻组(TO组)和常规全身麻醉组(GA组),每组30例。观察并记录两组患者各时点收缩压、舒张压、心率;麻醉诱导前(T0)、插管前即刻(T1)、切皮时(T2)、切除乳腺标本时(T3)、手术结束时(T4)各时点安静及运动状态下的疼痛视觉模拟评分量表(visual analogue scale,VAS);术后24 h 40项恢复质量评分量表(quality of recovery-40,QoR-40)评分;围术期不良反应的发生率。结果:与T0比较,两组患者T1~T4时点收缩压、舒张压、心率均显著降低(P <0.05),但两组之间各时点收缩压、舒张压、心率比较差异无统计学意义(P> 0.05);TO组术后2 h、6 h、12 h安静及运动状态下VAS评分均显著低于GA组(P <0.05);TO组术后24 h QoR-40量表总评分及情绪状态、身体舒适度、心理支持、疼痛各项评分均显著高于GA组(P <0.05);TO组患者诱导期咳嗽反射及术后恶心呕吐的发生率显著低于GA组(P <0.05)。结论:TTP-PECS阻滞联合羟考酮-丙泊酚减阿片药物全身麻醉可安全用于乳腺癌改良根治术中,术后镇痛效果确切,降低术后恶心呕吐发生率,并能提高患者早期恢复质量。

盐酸羟考酮对舌癌根治术患者术后血流动力学和氧化应激反应的影响

目的 探讨盐酸羟考酮对舌癌根治术患者术后血流动力学和氧化应激反应的影响。方法 选取医院2021年2月至2022年2月行舌癌根治术的舌癌患者113例,按随机数字表法分为观察组(57例)和对照组(56例)。两组患者均采用舒苏太尼复合咪达唑仑进行麻醉诱导,右美托咪定复合瑞芬太尼进行麻醉维持。术后,观察组给予盐酸羟考酮自控镇痛泵,对照组给予舒芬太尼自控镇痛泵。结果 术后2,6,24 h,观察组患者的平均动脉压、心率均显著低于对照组(P <0.05);观察组患者的苏醒期血清血红素加氧酶-1、超氧化物歧化酶水平均显著高于对照组(P <0.05),丙二醛水平显著低于对照组(P <0.05);观察组患者术毕警觉-镇静分级量表(OAA/S)评分显著高于对照组(P <0.05),疼痛数字等级评定量表(NRS)评分显著低于对照组(P <0.05);两组患者的苏醒时间、不良反应发生率相当(P> 0.05)。结论 盐酸羟考酮用于舌癌根治术患者的术后镇痛,可有效缓解患者的术后疼痛程度,减轻氧化应激反应,稳定围术期血流动力学水平,且不影响麻醉苏醒时间,安全性高。