[1]林志坚 王增春 赵秋燕 黄飞彬.羟考酮和芬太尼用于妇科腹腔镜手术术后镇痛的效果比较[J].福建医药杂志,2020,42(06):25-29.
　LIN Zhijian,WANG Zengchun,ZHAO Qiuyan,et al.Comparison of effects of oxycodone and fentanyl for postoperative analgesia of gynecological laparoscopic surgery[J].FUJIAN MEDICAL JOURNAL,2020,42(06):25-29.
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羟考酮和芬太尼用于妇科腹腔镜手术术后镇痛的效果比较()
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
42
期数:
2020年06期
页码:
25-29
栏目:
临床研究
出版日期:
2020-12-15

文章信息/Info

Title:
Comparison of effects of oxycodone and fentanyl for postoperative analgesia of gynecological laparoscopic surgery
文章编号:
1002-2600(2020)06-0025-05
作者:
林志坚 王增春1 赵秋燕 黄飞彬
福建医科大学附属漳州市医院麻醉科(漳州 363000)
Author(s):
LIN Zhijian; WANG Zengchun; ZHAO Qiuyan; HUANG Feibin.
Department of Anesthesiology, the Affiliated Zhangzhou Municipal Hospital,Fujian Medical University, Zhangzhou, Fujian 363000, China
关键词:
羟考酮;  芬太尼;  妇科腹腔镜;  术后镇痛
Keywords:
oxycodone;  fentanyl;  gynecological laparoscopic;  postoperative analgesia
分类号:
R614
文献标志码:
B
摘要:
目的 观察羟考酮对妇科腹腔镜手术术后镇痛的影响。方法 选取拟择期行腹腔镜手术的妇科患者80例,年龄18～53岁,ASAⅠ～Ⅱ级。将患者随机分为两组:羟考酮组(O组)和芬太尼组(F组),两组分别于关腹前5 min给予静脉注射羟考酮10 mg和芬太尼0.1 mg。记录拔管后15、30及60 min时的数字评价量表(NRS)评分、Ramsay镇静评分并观察是否呼吸抑制发生; 记录术后2、4、8、12和24 h静息和活动时的NRS评分; 记录术后首次出现NRS≥4分的时间、术后要求追加镇痛的例数、术后恶心呕吐(PONV)的例数; 评估术后24 h患者满意度并进行舒适度(BCS)评分。结果 两组拔管后15、30及60 min时的NRS评分和Ramsay镇静评分差异无统计学意义,也均未发生呼吸抑制; O组术后2、4、8 h静息和运动的NRS评分显著低于F组(P<0.05),而两组术后12 h与24 h时静息和活动的NRS评分差异无统计学意义; O组术后首次出现NRS≥4分的时间显著大于F组(P<0.05),而且术后要求给予追加镇痛的例数也少于F组(P<0.05); O组PONV发生率低于F组(P<0.05); O组术后24 h的患者满意度明显高于F组(P<0.05); 两组术后24 h BCS舒适度评分差异无统计学意义(P>0.05)。结论 羟考酮能有效缓解妇科腔镜术后早期疼痛,时效性明显; 且较于芬太尼,羟考酮作为术后镇痛中的阿片类药物,其相关不良反应的发生率也明显降低。
Abstract:
Objective To explore the clinical effect of oxycodone for postoperative analgesia of gynecological laparoscopic surgery.Methods Eighty patients undergoing elective gynecologic laparoscopic surgery,aged 18 to 53 years,with ASA physical statusⅠorⅡ, were randomly divided into two groups(n=40): oxycodone group(group O)and fentanyl group(group F).Five minutes before closure, oxycodone 10 mg was injected intravenously in group O and fentanyl 0.1 mg in group F.NRS(numerical rating scale)score, Ramsay sedation score and respiratory depression score 15, 30 and 60 min after extubation were recorded.Then the NRS score 2,4,8,12 and 24 hours after operation during rest or movement were recorded.The time for the NRS score more than or equal to four, the number of patients asking for additional analgesia, and the adverse reactions such as PONV were recorded.The satisfaction degree of analgesia and BCS scores in 24 hours were also evaluated.Results There was no difference in the NRS score and Ramsay sedation score at 15,30, 60 min after extubation(P>0.05).No respiratory depression occured in either group.The NRS score during rest or movement in group O at 2, 4 and 8 hours after surgery were significantly lower than those in the group F(P<0.05),but there was no statistically significant difference in NRS pain scores at 12 hours to 24 hours after extubation.Comparison with group F, the first time for the NRS more than or equal to four was much longer(P<0.05), and the number of cases asking for additional analgesia was much less in group O(P<0.05).The incidence of postoperative nausea and vomiting in group O was lower(P<0.05).Patients of group O got a higher degree of satisfaction(P<0.05).The BCS scores of 24 hours after operation had no statistically significant difference in two groups(P>0.05).Conclusion Oxycodone has exactly analgesic effect for laparoscopic gynecologic surgery,which can effectively alleviate the early postoperative pain in minimally invasive surgery.The analgesic limitation has obvious pertinence.Compared with fentanyl,oxycodone has a significantly lower rate of adverse reactions.

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备注/Memo

备注/Memo:
通信作者,福建医科大学附属协和医院心脏外科(福州350001),电子信箱:wzcfriendly2015@163.com
更新日期/Last Update: 1900-01-01