摘要
目的研究盐酸羟考酮用于腰椎后路椎体融合内固定术(PLIF)患者围术期麻醉管理的有效性及安全性。方法纳入2020年8-11月在解放军总医院第四医学中心行PLIF患者,按随机双盲数字表法分为舒芬太尼组(Suf组)和盐酸羟考酮组(Oxy组),每组40例。麻醉诱导应用舒芬太尼(0.2µg/kg)或盐酸羟考酮(0.08 mg/kg)、咪达唑仑(0.03 mg/kg)、依托咪酯(0.1 mg/kg)、丙泊酚(1 mg/kg)及罗库溴铵(1 mg/kg);术中采用静脉吸入复合维持麻醉。术后患者应用静脉自控镇痛泵,依据分组给予舒芬太尼(2µg/kg)或盐酸羟考酮(0.6 mg/kg)。记录麻醉诱导前(T_(1))、插管后2 min(T_(2))、手术开始后15 min(T_(3))、手术中点(T_(4))、手术结束前15 min(T5)和出手术室时(T6)的平均动脉压和心率,同时记录患者术后2、6、12、24、48及72 h的视觉模拟评分法(VAS)评分、排气时间、下床时间及术后不良反应情况。结果Oxy组患者术中血压变化幅度较小,在插管后2 min及手术结束前15 min的平均动脉压明显高于Suf组,差异均具有统计学意义(P<0.05)。与Suf组相比较,Oxy组术后24 h内各时间点VAS评分更低,患者满意度更高,且差异均具有统计学意义(P<0.05)。结论盐酸羟考酮用于腰椎后路椎体融合内固定术患者围术期全程麻醉管理,术中循环较稳定,术后镇痛效果好,患者满意度高。
Objective To observe the peri⁃operative safety and analgesic effect of oxycodone hydrochloride for lumbar interbody fusion and internal fixation in adults.Methods Eighty patients undergoing posterior lumbar surgery in the Fourth Medical Center of Chinses PLA General Hospital between August 2020 and November 2020 were divided into two groups(40 in each)using the random number table method:the sufentanil group(group Suf)and oxycodone hydro⁃chloride group(group Oxy).Anesthesia was induced with sufentanil(0.2µg/kg)or oxycodone hydrochloride(0.08 mg/kg),midazolam(0.03 mg/kg),etomidate(0.1 mg/kg),propofol(1 mg/kg),rocuronium(1 mg/kg).Anesthesia was maintained with sevoflurane balanced anesthesia.All patients after posterior lumbar operations were treated with patient controlled intravenous analgesia(PCIA).The patients in group Suf were given sufentanil(2µg/kg)diluted with 0.9%normal saline to 0.1 L while those in group Oxy were given oxycodone hydrochloride(0.6 mg/kg)diluted with 0.9%normal saline to 0.1 L.The values of mean arterial pressure(MAP)and heart rate(HR)of the two groups was recorded in the operating room(T_(1)),2 min after endotracheal intubation(T_(2)),15 min into the operation(T_(3)),the midpoint of the operation(T_(4)),15 min before the end of the operation(T_(5))and when the patient left room(T_(6)).The Visual Analogue Scale(VAS)scores and adverse reactions were recorded at 2,6,12,24,48,72 h after the operation,so was the time of the first exhaust and ambulation.Results The change in blood pressure in group Oxy was more stable.Mean arterial pressure(MAP)was significantly higher than that in group Suf 2 minutes after intubation and 15 minutes before the end of operation(P<0.05).Compared with group Suf,group Oxy had lower VAS scores at each time point within 24 hours of operation but higher levels of patient satisfaction,and the difference was statistically significant(P<0.05).Conclusion Compared with sufentanil,oxycodone hydrochloride attenuates hemodynamic responses and has better postoperative an
作者
郝薏晴
李萌萌
黄璜
房晓燕
孟令超
武健
陈小红
HAO Yi-qing;LI Meng-meng;HUANG Huang;FANG Xiao-yan;MENG Ling-chao;WU Jian;CHEN Xiao-hong(Jinzhou Medical University Postgraduate Training Center,the Fourth Medical Center,Chinese PLA General Hospital,Beijing 100048,China;Department of Anesthesiology,the Fourth Medical Center,Chinese PLA General Hospital,Beijing 100048,China)
出处
《军事医学》
CAS
2022年第1期59-63,共5页
Military Medical Sciences
基金
国家自然科学基金(81272030)
吴阶平医学基金会临床科研专项资助基金(320.6750.13220)。
关键词
盐酸羟考酮
舒芬太尼
腰椎后路椎体融合内固定术
围术期麻醉管理
oxycodone hydrochloride
sufentanil
posterior lumbar interbody fusion
peri-operative anesthesia management
