天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (5): 542-544.doi: 10.11958/j.issn.0253-9896.2015.05.025

• 药物临床观察 • 上一篇    下一篇

单剂量盐酸羟考酮和地佐辛用于妇科腔镜手术术后镇痛效应的比较

申军梅， 宋子贤， 雍芳芳， 朱康生， 贾慧群△#br#   

  1. 河北医科大学第四医院麻醉科 （邮编050011）
  • 收稿日期:2015-01-05 修回日期:2015-02-09 出版日期:2015-05-15 发布日期:2015-05-25
  • 通讯作者: 贾慧群,E-mail:mazuixueke@sina.com E-mail:fsfjc2010@163.com
  • 作者简介:申军梅 （1980）， 女， 主治医师， 硕士， 主要从事临床麻醉药理、 围术期血液保护等方面研究

Comparison of postoperative analgesic effect between the single dose of oxycodone and dezocine in patients undergoing gynecological laparoscopic operation

SHEN Junmei, SONG Zixian, YONG Fangfang, ZHU Kangsheng， JIA Huiqun△#br# #br#   

  1. Department of Anesthesiology, The Forth Hospital of Hebei Medical University,Shijiazhuang 050011, China
  • Received:2015-01-05 Revised:2015-02-09 Published:2015-05-15 Online:2015-05-25
  • Contact: JIA Huiqun,E-mail:mazuixueke@sina.com E-mail:fsfjc2010@163.com

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摘要： 摘要:目的 比较单剂量盐酸羟考酮和地佐辛用于妇科腔镜手术后的镇痛效果。方法 选择美国麻醉医师协会（ASA） Ⅰ或Ⅱ择期行全麻下妇科腹腔镜手术患者 60 例， 随机分为羟考酮组和地佐辛组， 各 30 例。手术结束前 15 min， 2 组分别给予羟考酮 0.1 mg/kg、 地佐辛 5 mg。手术结束前 20 min， 2 组均给予托烷司琼 5 mg。均采用靶控输注丙泊酚和瑞芬太尼进行麻醉诱导和维持。记录患者苏醒期躁动评分， 麻醉诱导前、 拔管前 5 min、 拔管时和拔管后 5 min 的平均动脉压 （MAP） 和心率 （HR）， 以及术后 2、 4、 6、 24 h 时静息、 运动疼痛视觉模拟 （VAS） 评分。当 VAS 评分> 40 时， 静脉注射曲马多 1 mg/kg， 记录镇痛补救例数， 术后恶心、 呕吐、 头晕、 发热、 呼吸抑制和瘙痒等不良反应的发生情况。结果 2 组苏醒期躁动评分， 不同时点 MAP、 HR 差异均无统计学意义。羟考酮组术后 2、 4 h 时静息 VAS 评分、 术后 2 h 时运动 VAS 评分均低于地佐辛组 （P＜0.05）， 其余时点与地佐辛组差异无统计学意义。羟考酮组除恶心的发生率高于地佐辛组外， 2 组其他不良反应的发生率和镇痛补救差异无统计学意义。结论 单剂量盐酸羟考酮 0.1 mg/kg 可用于妇科腔镜手术后镇痛， 其术后镇痛效果优于地佐辛， 但要注意不良反应恶心的发生。

关键词:  盐酸羟考酮, 地佐辛, 术后镇痛, 妇科腔镜手术

Abstract: Abstract: Objective To compare the postoperative analgesic effect of the single dose of oxycodone and dezocine in patients who underwent gynecological laparoscopic operation. Methods Sixty patients who underwent elective gynecologi⁃ cal laparoscopic operation were randomly divided into two groups (n=30): oxycodone group (group O) and dezocine group (group D). Fifteen minutes before the end of surgery, oxycodone 0.1 mg/kg was given in O group, and dezocine 5 mg was giv⁃ en to D group. Twenty minutes before the end of surgery, tropisetron 5 mg was given to both groups. Analgesia was main⁃ tained by propofol-remifentanil with TCI. The mean arterial pressure (MAP) and heart rate (HR) of T1, T2, T3 and T4 were recorded respectively in both two groups. After the operation, pain of visual analogue scale (VAS) was assessed in 2 h ,4 h , 6 h and 24 h, respectively. Results There were no significant differences in MAP and HR between two groups at T1, T2, T3 and T4 (P > 0.05). The VAS score was significantly lower in group O than that of group D (P < 0.05). There was significant difference in the incidence of nausea between the two groups (P < 0.05). Conclusion Single dose of oxycodone 0.1 mg/kg can be used for postoperative analgesia after gynecological laparoscopic operation, and which has better analgesia than that of dezocine, except for the adverse reaction of nausea.

Key words: Oxycodone, Dezocine, Postoperative analgesia, Gynecological laparoscopic operation