摘要
目的观察羟考酮用于子宫动脉栓塞术终止剖宫产后瘢痕妊娠的镇痛效果。方法选择2016年3月-2017年9月于保定市莲池区妇幼保健院行子宫动脉栓塞术介入治疗的瘢痕妊娠患者60例,年龄26~43岁,美国麻醉协会(ASA)分级Ⅰ~Ⅱ级,随机分为两组(每组n=30),分别于手术结束前10 min静注羟考酮0.05 mg/kg(O组)和舒芬太尼0.05μg/kg(S组),并连接患者自控静脉镇痛泵(PCIA)(配方:O组羟考酮0.8 mg/kg+托烷司琼10 mg+0.9%氯化钠注射液至100 ml;S组舒芬太尼0.8μg/kg+托烷司琼10 mg+0.9%氯化钠注射液至100 ml)。记录术后0.5 h、1 h、2 h、4 h、8 h、12 h、24 h和48 h患者的VAS疼痛评分、PCIA泵按压次数,镇痛药追加例数及不良反应情况。结果两组一般资料差异无统计学意义。术后1 h VAS疼痛评分O组[2(0~3)]低于S组[3(1~4)](P=0.012 1);术后2 h VAS疼痛评分O组[2(0~3)]低于S组[3(1~5)](P=0.009 2);术后4 h VAS疼痛评分O组[3(2~4)]低于S组[3(2~5)](P=0.013 4);术后8 h VAS疼痛评分O组[3(1~3)]低于S组[3(1~5)](P=0.047 5);术后12 h VAS疼痛评分O组2(1-3)低于S组3(2-4),(P=0.007 2),两组差异均有统计学意义。0.5 h、24 h及48 h VAS疼痛评分两组差异无统计学意义(P>0.05)。O组PCIA有效按压次数(1.9±0.4)次低于S组的(7.6±0.7)次(P=0.001 2);O组PCIA总按压次数(3.1±0.3)次低于S组的(12.8±1.2)次(P=0.002 3);O组镇痛药物追加1例(3%)低于S组的5例(17%)(P=0.003 6),差异均有统计学意义。两组患者不良反应发生率差异无统计学意义(P>0.05)。结论羟考酮缓解子宫动脉栓塞术终止剖宫产后瘢痕妊娠患者术后疼痛的效果优于舒芬太尼。
Objective To observe the analgesic effect of oxycodone for patients with cesarean scar pregnancy undergoing uterine arterial embolization. Methods Sixty patients with cesaren scar pregnancy who underwent uterine arterial embolization in Lianchi Maternity and Child Care Hospital from March 2016 to September 2017 were included in this study. These patients aged 26 to 43 years with ASA physical status Ⅰ - Ⅱ , were randomly divided into two groups, 30 cases in each group. Patients in group O were intravenously injected with oxycodone （0.05 mg/kg） at 10 minutes before the end of surgery, and then received controlled intravenous anagelsia （PCIA） with solution including oxycodone （0.8 mg/kg） plus tropisetron （10 mg）. Patients in group S were intravenously injected with sufentanyl （0.05 μ g/kg） at 10 minutes before the end of surgery, and then received PCIA with solution including sufentanyl （0.8 μ g/kg） plus tropisetron （10 mg）. The score of visual analogue scale （VAS） at 0.5, 1, 2, 8, 12, 24 and 48 hours after surgery, the times of patient controlled pressing, requirement for rescue analgesic and complications were recorded. Results There was no significant difference in demographic data between the two groups. The VAS scores were 2（0-3） in group O vs 3（1-4） in group S at 1 h （P=0.012 1）, 2（0-3） in group Ovs 3（1-5） in group S at 2 h （P=0.009 2）, 3（2-4） in group Ovs 3（2-5） in group S at 4 h （P=0.013 4）, 3（1-3） in group O vs 3（1-5） in group S at 8 h （P=0.047 5）, 2（1-3） in group Ovs 3（2-4） in group S at 12 h （P=0.007 2） after surgery. However, there was no significant difference in VAS between group O and group S at 0.5, 12 and 24 h after surgery （all P 〉 0.05）. The times of successful delivery in group O were lower than that of group S [（1.9 ± 0.4） vs （7.6 ±0.7）, （P=0.001 2）]. The times of total demand in group O were lower than that of group S [（3.1± 0.3） vs （12.8 ± 1.2）, （P=0.002 3）]. The
出处
《解放军医学院学报》
CAS
2018年第1期28-30,共3页
Academic Journal of Chinese PLA Medical School
关键词
羟考酮
子宫动脉栓塞术
剖宫产后瘢痕妊娠
镇痛
oxycodone
uterine artery embolization
pregnancy after cesarean section
analgesia
