摘要
目的观察盐酸羟考酮联合腹横肌平面(TAP)阻滞用于腹腔镜结肠癌根治术术后镇痛的效果。方法选择我院择期全身麻醉下行腹腔镜结肠癌根治术患者80例,随机分为4组,每组20例。T组麻醉诱导后术前超声引导下0.5%罗哌卡因200 mg双侧TAP阻滞;S组麻醉诱导后术前双侧TAP阻滞,术毕静脉注射舒芬太尼0.075μg/kg;O组麻醉诱导后术前双侧TAP阻滞,术毕静脉注射盐酸羟考酮0.075 mg/kg;C组术前不行TAP阻滞,术毕等量生理盐水静脉注射。记录四组患者术后1、6、12、24、48 h视觉模拟疼痛评分(VAS)及术后Ramsay镇静评分,记录术后舒芬太尼补救镇痛率、总体镇痛满意度及不良反应发生率。结果与C组比较,T组、S组和O组术后VAS评分和补救镇痛率降低(P<0.05);与T组比较,O组术后VAS评分和补救镇痛率降低(P<0.05)。与C组比较,S组术后1h Ramsay评分增高(P<0.05)。与C组比较,T组、S组和O组术后总体镇痛满意度增高(P<0.05);与T组比较,O组总体镇痛满意度增高(P<0.05)。四组恶心、呕吐、皮肤瘙痒、呼吸抑制等不良反应发生率比较差异无统计学意义(P>0.05)。结论盐酸羟考酮联合腹横肌平面阻滞能有效缓解腹腔镜结肠癌根治术术后疼痛,而且不增加不良反应发生率。
Objective To evaluate the postoperative analgesic efficacy of oxycodone hydrochloride combined with transversus abdominis plane（TAP） block in patients undergoing laparoscopic radical resection of colonic carcinoma.Methods Eighty patients scheduled for laparoscopic radical resection of colonic carcinoma under general anesthesia were randomly divided into 4 groups,20 cases in each group.In group T,0.5%ropivacaine 200 mg was used into bilateral TAP block with ultrasonic guidance after anesthesia induction.In group S and group O,bilateral TAP block was performed after anesthesia induction,in addition,sufentanil 0.075 μg/kg or oxycodone hydrochloride 0.075 mg/kg was injected intravenously immediately after operation.In group C,TAP block was not performed and equal volume saline was injected intravenously immediately after operation.The Visual analog scale（VAS） and postoperative Ramsay sedation score were recorded at 1,6,12,24,48 h after operation,and the remedial rate of postoperative analgesia with sufentanil pverall analgesia satisfaction and incidence of adverse reactions were also recorded.Results The VAS and remedial rate of postoperative analgesia in group T,group S and group O were lower than those of group C（P 〈0.05）,and the indexes in group O were lower than those of group T（P 〈 0.05）.The Ramsay score in group S was higher than that of group C at 1 h after operation（P 〈 0.05）.The overall analgesia satisfaction in group T group S and group O was higher than that of group C（P 〈0.05）,and the satisfaction in group O was higher than that of group T（P 〈 0.05）,There was no significant difference in adverse reactions,such as nausea,vomiting,skin itching and respiratory depression among the four groups（P 〉0.05）.Conclusion Oxycodone hydrochloride combined with TAP block can effectively relieve the postoperative pain of laparoscopic radical resection of colonic carcinoma and do not increase the incidence of adverse reactions.
出处
《实用药物与临床》
CAS
2016年第2期179-182,共4页
Practical Pharmacy and Clinical Remedies
基金
国家自然科学基金(81401000)
辽宁省博士科研启动基金项目(20141035)
关键词
盐酸羟考酮
腹横肌平面阻滞
镇痛
Oxycodone hydrochloride
Transversus abdominis plane block
Analgesia
