羟考酮用于腹腔镜直肠癌根治术患者术后静脉自控镇痛的临床观察
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摘要
目的观察羟考酮用于腹腔镜直肠癌根治术患者术后自控镇痛效果。方法取择期行全麻下腹腔镜直肠癌根治术患者120例,随机分为4组,每组30例。O组:1.25 mg/kg羟考酮盐水稀释至100 ml;S组:2.5μg/kg舒芬太尼盐水稀释至100 ml;D组:1 mg/kg地佐辛盐水稀释至100 ml;F组:25μg/kg芬太尼盐水稀释至100 ml。观察比较术后3 h、6 h、12 h、24 h的VAS评分、Ramsay评分、按压次数、不良反应的发生情况及患者的满意度等。结果术后3 h、6 h O组的切口痛的VAS评分显著低于D组和F组(P<0.05),在各个时间点O组和S组比较,术后切口痛VAS评分差异无统计学意义(P>0.05),术后内脏痛的VAS评分,O组在3h、6h、12h时间点显著低于其余三组(P<0.05)。结论羟考酮可安全用于腹腔镜直肠癌手术患者的术后自控镇痛(PCA),镇痛效果强,不良反应少。
Objective To observe the effect of oxycodone on patient-controlled analgesia(PCA) after laparoscopic radical resection of rectal cancer.Methods A total of one hundred and twenty patients undergoing laparoscopic radical resection of rectal cancer under general anesthesia were randomly divided into 4 groups,30 cases in each group.Group O:1.25 mg/kg oxycodone saline diluted to 100 ml; group S:2.5 μg/kg sufentanil saline diluted to 100 ml; group D:1 mg/kg dizosin saline diluted to 100 ml; group F:25 μg/kg fentanyl saline diluted to 100 ml.VAS scores,Ramsay scores,pressing times,adverse reactions and patients′satisfaction at 3,6,12 and 24 h after operation were observed and compared.Results VAS score of incision pain in group O was significantly lower than that in group D and F at 3 h and 6 h after operation(P<0.05).There was no significant difference in VAS score of incision pain between group O and group S at different time points(P>0.05).The VAS score of visceral pain in group O was significantly lower than that in other three groups at 3 h,6 h and 12 h(P<0.05).Conclusion Oxycodone can safely and effectively relieve the postoperative pain for PCA after laparoscopic radical resection of rectal cancer and it may be a useful alternative in the treatment of visceral pain.
Objective To observe the effect of oxycodone on patient-controlled analgesia(PCA) after laparoscopic radical resection of rectal cancer.Methods A total of one hundred and twenty patients undergoing laparoscopic radical resection of rectal cancer under general anesthesia were randomly divided into 4 groups,30 cases in each group.Group O:1.25 mg/kg oxycodone saline diluted to 100 ml; group S:2.5 μg/kg sufentanil saline diluted to 100 ml; group D:1 mg/kg dizosin saline diluted to 100 ml; group F:25 μg/kg fentanyl saline diluted to 100 ml.VAS scores,Ramsay scores,pressing times,adverse reactions and patients′satisfaction at 3,6,12 and 24 h after operation were observed and compared.Results VAS score of incision pain in group O was significantly lower than that in group D and F at 3 h and 6 h after operation(P<0.05).There was no significant difference in VAS score of incision pain between group O and group S at different time points(P>0.05).The VAS score of visceral pain in group O was significantly lower than that in other three groups at 3 h,6 h and 12 h(P<0.05).Conclusion Oxycodone can safely and effectively relieve the postoperative pain for PCA after laparoscopic radical resection of rectal cancer and it may be a useful alternative in the treatment of visceral pain.
引文
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[11] 胡庆丰.盐酸羟考酮控释片治疗癌性疼痛临床观察[J].中国煤炭工业医学杂志,2009,12(3):404
[12] 杨洋,吴夏慧,罗毅.盐酸羟考酮缓释片与硫酸吗啡缓释片治疗老年患者中重度癌痛的效果和安全性比较[J].中国医药,2018,13(5):725-728
[13] 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
[14] Hwang B,Kwon J,Kim E,et al.Oxycodone vs.Fentanyl Patient-Controlled Analgesia after Laparoscopic Cholecystectomy[J].Int J Med Sci,2014,11(7):658-662
[15] Park J,Lee C,Shin Y,et al.Comparison of oxycodone and fentanyl for postoperative patient-controlled analgesia after laparoscopic gynecological surgery[J].Kor J Anesth,2015,68(2):153
[16] Jung K W,Kang H W,Park C H,et al.Comparison of the Analgesic Effect of Patient-controlled Oxycodone and Fentanyl for Pain Management in Patients Undergoing Colorectal Surgery[J].Clin Exp Pharmacol Physiol,2016,43(8):745-752
[17] Li Z,Wu H,He R,et al.Oxycodone versus dezocine for postoperative analgesia in patients with cervical cancer treated with radical surgery[J].J Cancer Res Ther,2016,12(Suppl):27-29
[2] 魏威,徐应军,张国志.腹腔镜结直肠癌手术应用及发展趋势[J].中国煤炭工业医学杂志,2015,18(11):1952-1956
[3] 马磊.腹腔镜下直肠癌根治术与传统开腹手术患者术后近期获益对比分析[J].中国煤炭工业医学杂志,2016,19(01):46-49
[4] Davis M P,Goforth H W.Oxycodone with an opioid receptor antagonist:A review[J].J Opioid Manag,2016,12(1):67-85
[5] 宋君利,杜家宜,黄彩云,等.盐酸羟考酮缓释片直肠给药治疗中重度肝癌疼痛的疗效观察[J].中国煤炭工业医学杂志,2014,17(07):1080-1082
[6] Wang J,Ma H,Zhou H,et al.Effect of preoperative intravenous oxycodone administration on sufentanil consumption after retroperitoneal laparoscopic nephrectomy[J].Anaesthesiol Intensive Ther,2016,48(5):300-304
[7] Na W,Zhou H,Song X,et al.Comparison of oxycodone and sufentanil for patient-controlled intravenous analgesia after laparoscopic radical gastrectomy:A randomized double-blind clinical trial[J].Anesth Essays Res,2016,10(3):557-560
[8] Thong I S K,Jensen M P,Jordi Miró,et al.The validity of pain intensity measures:what do the NRS,VAS,VRS,and FPS-R measure[J].Scand J Pain,2018,18(1):99-107
[9] Blichfeldt-Eckhardt M R,Ording H,Andersen C,et al.Early visceral pain predicts chronic pain after laparoscopic cholecystectomy[J].Pain,2014,155(11):2400-2407
[10] Kokki H,Kokki M,Sjovall S.Oxycodone for the treatment of postoperative pain[J].Expert Opin Pharmacother,2012,13(7):1045-1058
[11] 胡庆丰.盐酸羟考酮控释片治疗癌性疼痛临床观察[J].中国煤炭工业医学杂志,2009,12(3):404
[12] 杨洋,吴夏慧,罗毅.盐酸羟考酮缓释片与硫酸吗啡缓释片治疗老年患者中重度癌痛的效果和安全性比较[J].中国医药,2018,13(5):725-728
[13] 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
[14] Hwang B,Kwon J,Kim E,et al.Oxycodone vs.Fentanyl Patient-Controlled Analgesia after Laparoscopic Cholecystectomy[J].Int J Med Sci,2014,11(7):658-662
[15] Park J,Lee C,Shin Y,et al.Comparison of oxycodone and fentanyl for postoperative patient-controlled analgesia after laparoscopic gynecological surgery[J].Kor J Anesth,2015,68(2):153
[16] Jung K W,Kang H W,Park C H,et al.Comparison of the Analgesic Effect of Patient-controlled Oxycodone and Fentanyl for Pain Management in Patients Undergoing Colorectal Surgery[J].Clin Exp Pharmacol Physiol,2016,43(8):745-752
[17] Li Z,Wu H,He R,et al.Oxycodone versus dezocine for postoperative analgesia in patients with cervical cancer treated with radical surgery[J].J Cancer Res Ther,2016,12(Suppl):27-29