羟考酮对腹腔镜宫颈癌根治术患者术后疼痛的影响
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摘要
目的探讨羟考酮对腹腔镜宫颈癌根治术患者术后切口痛和内脏痛的影响。方法60例腹腔镜宫颈癌根治术患者随机均分为四组。关腹时,O组、F组和K组分别静脉给予羟考酮5mg、芬太尼0.05mg和氟比洛芬酯50mg,C组给予等容量生理盐水。记录患者苏醒时间、麻醉后恢复室(PACU)停留时间,评估拔管后5min、拔管后15min和离开PACU前的切口及内脏VAS疼痛评分(IV1、IV2和IV3及VV1、VV2和VV3),记录离开PACU前Ramsay评分、术后不良反应发生情况和手术前后血气分析结果。结果 C组PACU停留时间长于其他三组(P<0.05)。四组的苏醒时间、Ramsay评分、术后不良反应发生率、手术前后PaO2和PaCO2差值比较均无统计学差异(P>0.05)。O组、F组和K组的IV1、IV2和IV3均低于C组(P<0.05),O组的VV1、VV2和VV3均低于K组、F组和C组(P<0.05)。结论腹腔镜宫颈癌根治术患者手术结束前静脉给予羟考酮5mg可以明显缓解术后切口痛及内脏痛,且不增加术后不良反应发生率。
Objective To investigate the effect of oxycodone on postoperative incisional pain and visceral pain in the patients undergoing laparoscopic radical resection of cervical cancer.Methods Sixty patients undergoing laparoscopic radical resection of cervical cancer were randomly and equally divided into four groups.Before the abdomen was closed,the patients in groups of O,F,K and C were given intravenous injection of oxycodone 5 mg,fentanyl 0.05 mg,flurbiprofen 50 mg and same volume of normal saline,respectively.The time for waking up,PACU stay,incisional and visceral VAS pain scores at 5 minutes after extubation(IV1 and VV1),15 minutes after extubation(IV2 and VV2)and before leaving PACU(IV3 and VV3) were recorded.Ramsay score before leaving PACU,postoperative adverse responses and blood gas analysis before and after the operation were recorded as well.Results The PACU stay time of group C was longer than that of the other three groups(P<0.05).There were no significant differences in the time for waking up,Ramsay score,the incidence of postoperative adverse responses,and differences of PaO2 and PaCO2 before and after operation among four groups(P>0.05).The IV1,IV2 and IV3 in groups of O,F and K were lower than those in group C(P<0.05).The VV1,VV2 and VV3 in group O were lower than those in groups of F,K and C(P<0.05).Conclusion Intravenous injection of oxycodone 5 mg before the end of laparoscopic radical resection of cervical cancer can significantly attenuate postoperative incisional pain and visceral pain without increasing the incidence of postoperative adverse responses.
Objective To investigate the effect of oxycodone on postoperative incisional pain and visceral pain in the patients undergoing laparoscopic radical resection of cervical cancer.Methods Sixty patients undergoing laparoscopic radical resection of cervical cancer were randomly and equally divided into four groups.Before the abdomen was closed,the patients in groups of O,F,K and C were given intravenous injection of oxycodone 5 mg,fentanyl 0.05 mg,flurbiprofen 50 mg and same volume of normal saline,respectively.The time for waking up,PACU stay,incisional and visceral VAS pain scores at 5 minutes after extubation(IV1 and VV1),15 minutes after extubation(IV2 and VV2)and before leaving PACU(IV3 and VV3) were recorded.Ramsay score before leaving PACU,postoperative adverse responses and blood gas analysis before and after the operation were recorded as well.Results The PACU stay time of group C was longer than that of the other three groups(P<0.05).There were no significant differences in the time for waking up,Ramsay score,the incidence of postoperative adverse responses,and differences of PaO2 and PaCO2 before and after operation among four groups(P>0.05).The IV1,IV2 and IV3 in groups of O,F and K were lower than those in group C(P<0.05).The VV1,VV2 and VV3 in group O were lower than those in groups of F,K and C(P<0.05).Conclusion Intravenous injection of oxycodone 5 mg before the end of laparoscopic radical resection of cervical cancer can significantly attenuate postoperative incisional pain and visceral pain without increasing the incidence of postoperative adverse responses.
引文
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[6]吴周全,邹志清,陈勇.不同剂量羟考酮对腹部手术后急性疼痛的抑制作用[J].临床麻醉学杂志,2015,31(2):161-163.
[7]蒋宗明,宋棋梁,陈文迪,等.羟考酮用于老年患者腹腔镜胆囊切除术麻醉的可行性研究[J].医学研究杂志,2018,47(3):71-74.
[8]刘晓鹏,权哲峰,池萍,等.羟考酮与舒芬太尼用于无痛胃镜治疗术的比较[J].北京医学,2016,38(9):883-885.
[9]高亚蕾,王丽美,张灵威,等.羟考酮和舒芬太尼在术后恢复室治疗全麻患者早期术后疼痛的临床研究[J].中国血液流变学杂志,2015,25(2):171-173.
[2]许沄,杨慧云.腹腔镜宫颈癌根治术43例临床分析[J].江苏医药,2014,40(18):2198-2199.
[3]Benedet JL,Bender H,Jones H 3rd,et al.FIGO staging classifications and clinical practice guidelines in the management of gynecologic cancers.FIGO Committee on Gynecologic Oncology[J].Int J Gynaecol Obstet,2000,70(2):209-262.
[4]Lenz H,Sandvik L,Qvigstad E,et al.A comparison of intravenous oxycodone and intravenous morphine in patient-controlled postoperative analgesia after laparoscopic hysterectomy[J].Anesth Analg,2009,109(4):1279-1283.
[5]Koch S,Ahlburg P,Spangsberg N,et al.Oxycodone vs.fentanyl in the treatment of early post-operative pain after laparoscopic cholecystectomy:a randomised double-blind study[J].Acta Anaesthesiol Scand,2008,52(6):845-850.
[6]吴周全,邹志清,陈勇.不同剂量羟考酮对腹部手术后急性疼痛的抑制作用[J].临床麻醉学杂志,2015,31(2):161-163.
[7]蒋宗明,宋棋梁,陈文迪,等.羟考酮用于老年患者腹腔镜胆囊切除术麻醉的可行性研究[J].医学研究杂志,2018,47(3):71-74.
[8]刘晓鹏,权哲峰,池萍,等.羟考酮与舒芬太尼用于无痛胃镜治疗术的比较[J].北京医学,2016,38(9):883-885.
[9]高亚蕾,王丽美,张灵威,等.羟考酮和舒芬太尼在术后恢复室治疗全麻患者早期术后疼痛的临床研究[J].中国血液流变学杂志,2015,25(2):171-173.