摘要
目的比较盐酸羟考酮与枸橼酸舒芬太尼用于腹腔镜胆囊切除术(LC)麻醉诱导的麻醉及镇痛效果。方法择期LC术患者60例,美国麻醉医师协会分级(ASA)Ⅰ或Ⅱ级,采用随机数字表法分为两组:羟考酮组(O组)及舒芬太尼组(S组)。麻醉诱导:O组:静脉注射丙泊酚1.0~2.0 mg/kg、羟考酮0.3 mg/kg、维库溴铵0.1 mg/kg;S组:静脉注射丙泊酚1.0~2.0 mg/kg、舒芬太尼0.3μg/kg、维库溴铵0.1 mg/kg。麻醉维持采用常用的静吸复合药物。记录入手术室后(T0)、麻醉诱导后置入喉罩前(T1)、麻醉诱导置入喉罩后1 min(T2)、建立人工气腹后(T3)、分离胆囊时(T4)、苏醒即刻(T5)和离开复苏室即刻(T6)时的心率(HR)、收缩压(SBP)、舒张压(DBP),记录苏醒即刻(T5)、离开复苏室即刻(T6)、术后4 h(T7)、术后8 h(T8)和术后第1天(T9)的疼痛数字等级评分(NRS),记录苏醒时间及术毕患者复苏过程中追加止痛药例数,观察术后患者不良反应情况。结果两组患者术中平均HR、SBP及DBP波动不超过基础值的20.0%。两组患者术毕苏醒时间无明显差异。S组苏醒后补救镇痛的比率为36.7%,较O组更多(P=0.040)。O组较S组在T5、T7、T8和T9等时间点疼痛NRS评分更低,但是差异无统计学意义。两组患者不良反应情况比较无明显差异。结论 0.3 mg/kg羟考酮与舒芬太尼0.3μg/kg用于LC手术麻醉诱导,患者麻醉及镇痛效果良好,能满足临床麻醉及术后镇痛需求。0.3 mg/kg的羟考酮有与0.3μg/kg的舒芬太尼相当或更好的镇痛作用。
Objective To compare the analgesia effects of Oxycodone hydrochloride with Sufentanil inlaparoscopic cholecystectomy(LC)anesthesia induction.Method Sixty patients scheduled for elective LC,ASAⅠorⅡ,were randomly divided into two groups(30in each):Oxycodone group(group O)and Sufentanil group(Group S).Induction of anesthesia:group O:Propofol1.0~2.0mg/kg,Oxycodone0.3mg/kg,Vecuronium0.1mg/kg.Group S:Propofol1.0~2.0mg/kg,Sufentanil0.3μg/kg and Vecuronium0.1mg/kg.The value of HR,SBP,DBPof the two groups were recorded in the operation room(T0),after anesthesia induction(T1),1min after insertionlaryngeal mask(T2),the instant of pneumoperitoneum establishment(T3),separation of the gallbladder(T4),the timeof wake up(T5),leave the recovery room(T6).The numeric pain rating scale(NRS)were recorded at T4,T5,4hourslater(T7),8hours later(T8),one day later(T9).Then recorded the wake time and additional analgetic cases.Recordedthe adverse reactions.Results The average HR,SBP and DBP fluctuations in the two groups were not more than20.0%of the basal values.There was no significant difference in wake time between the two groups.There were11cases of patients,the NRS>4,in Sufentanil group requires additional analgesics after they wake up,more thanOxycodone group(P=0.040).The NRS score was lower in Oxycodone group than group S in T5,T7,T8,T9,but theyhad no statistically significant difference.There was no significant difference in adverse reactions between the twogroups.Conclusion0.3mg/kg Oxycodone and0.3μg/kg Sufentanil for anesthesia induction of LC,the anesthesiaand analgesia effect is good,can satisfy the clinical anesthesia and postoperative analgesic requirements.Theanalgesic effect of0.3mg/kg Oxycodone may be comparable or better than0.3μg/kg Sufentanil.
作者
郭俊
吕华燕
胡崇辉
黄晓霞
张明途
Jun Guo;Hua-yan Lü;Chong-hui Hu;Xiao-xia Huang;Ming-tu Zhang(Department of Anesthesiology, Jinhua Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua,Zhejiang 321000, China)
出处
《中国内镜杂志》
北大核心
2017年第8期42-46,共5页
China Journal of Endoscopy
关键词
羟考酮
舒芬太尼
腹腔镜胆囊切除术
麻醉诱导
Oxycodone
Sufentanil
laparoscopic cholecystectomy
anesthesia induction
