摘要
目的 比较羟考酮与舒芬太尼用于肝硬化患者无痛胃镜治疗术的麻醉效果。方法 择期行胃镜下硬化剂治疗的病毒性肝炎肝硬化患者纳入本研究。性别不限,年龄18~65岁,Child-Pugh分级A级。采用随机数字表法,将其分为羟考酮组和舒芬太尼组。2组患者首先静脉注射咪达唑仑0.1 mg/kg,之后羟考酮组静脉注射羟考酮0.1 mg/kg,舒芬太尼组静脉注射舒芬太尼0.1μg/kg;3 min后根据警觉/镇静评分（OAA/S）〉1分时静脉追加丙泊酚,待OAA/S=1分时开始手术。记录围术期发生呼吸抑制、呛咳、皱眉、肢体活动和丙泊酚使用情况,术后发生恶心、呕吐、头晕、瘙痒、嗜睡的情况,对镇痛的满意率。结果 80例患者纳入本研究,2组患者一般资料和手术时间的差异无统计学意义（P〉0.05）;2组患者围术期血管活性药物使用情况的差异无统计学意义（P〉0.05）。羟考酮组丙泊酚使用率（30.0%vs.67.5%,P〈0.05）和围术期追加率（22.5%vs.57.5%,P〈0.05）显著低于舒芬太尼组,呼吸抑制率也显著降低（5.0%vs.32.5%,P〈0.05）,而术后镇痛的满意率显著提高（90.0%vs.62.5%,P〈0.05）。2组患者发生恶心、呕吐、头晕、瘙痒、嗜睡等不良反应比较,差异无统计学意义（P〉0.05）。结论 与舒芬太尼相比,羟考酮用于无痛胃镜治疗术更加安全,术后镇痛的满意率更高。
Objective To investigate the analgesic effect of oxycodone hydrochloride compared with sufentanil in patients with cirrhosis undergoing gastroscopy. Methods The cirrhosis patients who underwent gastroscopy with Child- Pugh A, and whose age were 18-65 years old, were randomly divided into the oxycodone group（group A） and the sufent- anil group （group B）. All paitents were administrated with midazolam 0.1 p,g/kg, but patients in group A were combined with oxycodone 0.1 mg/kg, while patients in group B were combined with sufentanil 0.1 p,g/kg. After 3 min, propofol was injected until OAA/S=I. Respiratory depression,cough, frown, body movement and usage of propofol during operation were recorded. Nausea, vomit, dizziness, pruritus, hypersomnia and analgesic effect after operation were also recorded. Results Eighty patients were recruited into the study, 40 in each group. There were no differences between the two groups in age,sex,body weight, operation duration,amount of vasoactive drugs,etc（P 〉 0.05）. The paitents in group A used less propofol at the beginning of operation（30.0% vs. 67.5%, P 〈 0.05） and needed less supplement during the perioperative period（22.5% vs. 57.5%, P 〈 0.05）. Group A had a lower incidence of respiratory depression（5.0% vs. 32.5%, P 〈 0.05）. More paitents satisfied with postoperative analgesia in group A（90.0% vs. 62.5%, P 〈 0.05）. There were no significant differences in other events（P 〉 0.05）. Conclusion Oxycodone is safer and have a better analgesic effect than sufentanil in anesthesia for gastroscopy.
出处
《北京医学》
CAS
2016年第9期883-885,共3页
Beijing Medical Journal
关键词
羟考酮
舒芬太尼
静脉麻醉
胃镜治疗
呼吸抑制
oxycodone
sufentanil
intravenous anesthesia
endoscopic treatment
respiratory depression
