| 羟考酮与舒芬太尼用于腹腔镜胃肠外科手术麻醉的效果比较 |
| 投稿时间：2019-12-30 修订日期：2020-02-04 点此下载全文 |
| 引用本文：普隽,李永华,羊黎晔.羟考酮与舒芬太尼用于腹腔镜胃肠外科手术麻醉的效果比较[J].药学实践杂志,2020,38(3):268~272 |
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| 基金项目:国家自然科学基金面上项目（81873945）；上海市卫生健康委先进适宜技术推广项目（2019SY019）；上海市人才发展资金计划（2019049） |
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| 中文摘要:目的 比较舒芬太尼与羟考酮在腹腔镜胃肠癌手术患者围术期应用的有效性和安全性。方法 纳入全麻行腹腔镜胃癌或肠癌择期手术患者59例，随机分为舒芬太尼组（S组）和羟考酮组（O组）。常规麻醉诱导，S组静脉推注舒芬太尼0.3 μg/kg，O组静脉推注羟考酮0.3 mg/kg。术中采用静吸复合麻醉，根据血压或心率变化追加药物，O组静脉推注羟考酮0.1 mg/kg，S组静脉推注舒芬太尼0.1 μg/kg。手术结束前30 min，S组静脉推注舒芬太尼0.1 μg/kg，O组静脉推注羟考酮0.1 mg/kg。术后2 h，如视觉模拟评分（VAS）>4，行镇痛补救：S组静脉推注舒芬太尼0.1 μg/kg，O组静脉推注羟考酮0.1 mg/kg。记录围术期两组患者的血压、心率、VAS评分、需要镇痛补救的次数、镇静评分(Ramsay评分)和不良反应的发生率。结果 围术期两组患者的血压、心率、VAS评分、镇痛补救次数，两组间比较无统计学差异（P>0.05）；术后Ramsay评分O组显著高于S组（P=0.014）；诱导期呛咳的发生率O组显著低于S组（P=0.002）；术后躁动的发生率O组显著低于S组（P=0.045）；恶心呕吐、呼吸抑制的发生率两组间差异无统计学意义（P> 0.05）。结论 羟考酮与舒芬太尼相比，可以显著降低腹腔镜胃肠外科手术患者诱导期呛咳和术后躁动的发生率，为该手术患者提供良好的镇静条件。 |
| 中文关键词:腹腔镜胃癌/肠癌 手术麻醉 围术期 舒芬太尼 羟考酮 |
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| Oxycodone versus sufentanil in patients undergoing laparoscopic gastrointestinal surgery |
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| Abstract:Objective To compare the perioperative application of sufentanil and oxycodone in patients undergoing laparoscopic surgery for gastric or colorectal cancer.Methods 59 patients were selected and randomly divided into group O and group S. Anesthesia was induced with sufentanil 0.3 μg/kg in group S and oxycodone 0.3 mg/kg in group O. Anesthesia was maintained with sevoflurane balanced anesthesia. When heart rate or blood pressure reached 20% over the baseline, additional dose of oxycodone 0.1 mg/kg was given in group O and sufentanil 0.1 μg/kg in group S. 30 minutes before the end of surgery, patients in group S received sufentanil 0.1 μg/kg and group O with oxycodone 0.1 mg/kg separately. Two hours in the PACU, a rescue dose of sufentanil 0.1 μg/kg or oxycodone 0.1 mg/kg was given to the patients with VAS score bigger than 4. Hemodynamic index, VAS score, Ramsay score, adverse responses and analgesics rescue were recorded.Results No difference was found in hemodynamic index, VAS score and analgesics rescue between the two groups (P>0.05). Ramsay score of group S is lower than that of group O (P=0.014). Induction period bucking incidence in group O was obviously lower than that in group S(P=0.002). The incidence of emergency agitation in group O was significantly lower than that in group S(P=0.045).There was no significant difference in respiratory depression, postoperative nausea and vomiting between two groups (P>0.05).Conclusion Compared with sufentanil, oxycodone significantly reduced the incidence of bucking and emergency agitation. Oxycodone provided better sedation to patients who received laparoscopic surgery for gastric or colorectal cancer. |
| keywords:laparoscopic gastric cancer/colorectal cancer surgical anesthesia perioperative sufentanil oxycodone |
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