摘要
目的评价羟考酮用于髋关节置换术后老年病人自控静脉镇痛的效果。方法择期全麻下行单侧髋关节置换术的老年病人60例，年龄65～85岁，体重42～89kg，性别不限，ASA分级Ⅰ或Ⅱ级，采用随机数字表法分为2组（n=30）：吗啡组（M组）和羟考酮组（O组）。麻醉诱导前30min静脉注射帕瑞昔布钠40mg，常规麻醉诱导和麻醉维持。缝皮时连接自控静脉镇痛泵，镇痛药液配方：M组吗啡0．6mg／kg＋托烷司琼10mg，0组羟考酮0．6mg／kg＋托烷司琼10mg，均用生理盐水稀释至100ml，背景输注速率2ml／h，PCA剂量为0．5ml，锁定时间为15min，维持VAS评分≤3分，镇痛至术后48h；当VAS评分≥4时肌肉注射哌替啶50mg。记录补救镇痛药物使用情况以及不良反应的发生情况。结果M组补救镇痛率为10％，O组无一例病人进行补救镇痛；与M组比较，O组补救镇痛率、恶心呕吐及皮肤瘙痒发生率降低（P〈0．05）。结论羟考酮用于髋关节置换术后老年病人自控静脉镇痛效果良好，不良反应少，提示羟考酮对重度躯体痛具有良好的镇痛效果。
Objective To evaluate the efficacy of oxycodone for patient-controlled intravenous anal- gesia （PCIA） after hip art hroplasty in elderly patients. Methods Sixty patients of both sexes, aged 65-85 yr, weighing 42-89 kg, Of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective unilateral hip arthroplasty under general anesthesia, were divided into 2 groups （n = 30 each） using a random number table： morphine group （ group M） and oxycodone group （ group O）. Parecoxib sodium 40 mg was injected intravenously at 30 min before induction of anesthesia, followed by induction and mainte- nance of anesthesia. PCIA pump was connected at the beginning of skin closure. PCIA solution contained morphine 0. 6 mg/kg and tropisetron 10 mg diluted to 100 ml in normal saline in group M and oxycodone 0. 6 mg/kg and tropisetron 10 mg diluted to 100 ml in normal saline in group O. The PCA pump was set up with a background infusion at 2 ml/h, a 0. 5 ml bolus dose and a 15 min lockout interval in both groups. Visual analogue scale score was .maintained ≤ 3, and postoperative analgesia lasted until 48 h after operation. When analogue scale score ≥ 4, pethidine 50 mg/kg was injected muscularly as rescue analgesic. The re- quirement for rescue analgesic and occurrence of adverse effects were recorded. Results Ten percent pa- tients required rescue analgesics in group M, and no patients required rescue analgesics in group O. Com- pared with group M, the requirement for rescue analgesics and incidence of nausea, vomiting and pruritus were significantly decreased in group O （P〈0. 05）. Conclusion Oxyeodone provides reliable efficacy for PCIA after hip arthroplasty in elderly patients with fewer adverse effects, indicating that oxyeodone produces good analgesic efficacy for severe somatalgia.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2016年第10期1229-1231,共3页
Chinese Journal of Anesthesiology
关键词
羟可酮
疼痛
手术后
镇痛
病人控制
老年人
关节成形术
置换
髋
Oxycodone
Pain, postoperative
Analgesia, patient-controlled
Aged
Arthro- plasty, replacement, hip
