摘要
目的评估羟考酮、氢吗啡酮与舒芬太尼对胃癌患者术后镇痛的临床疗效及不良反应。方法检索中山大学附属第五医院麻醉镇痛系统2020年6月1日至2022年6月31日进行胃癌根治手术治疗的胃癌患者,根据术后镇痛方案分为氢吗啡酮组(n=108),羟考酮组(n=35),舒芬太尼组(n=42)。收集所有患者年龄、性别、BMI、ASA分级、手术方式、淋巴结清扫、手术后并发症等一般基线资料。分别比较三组患者在术后4~8 h(T1)、10~14 h(T2)、22~26 h(T3)、46~50 h(T4)4个时段静息和活动的视觉模拟评分(VAS),术后48 h内自控镇痛泵按压次数及术后不良反应发生率。结果三组患者的一般资料,差异无统计学意义(P>0.05)。术后T1、T2、T3、T4时刻,羟考酮组和氢吗啡酮组镇痛效果优于舒芬太尼组,差异均有统计学意义(P<0.05);羟考酮组和氢吗啡酮组的镇痛效果一致(P>0.05)。羟考酮组和氢吗啡酮组48 h内镇痛泵总计自控按压次数少于舒芬太尼组(P<0.05);羟考酮组与氢吗啡酮组镇痛泵总计自控按压次数无差异(P>0.05)。三种镇痛方案的不良反应总发生率无差异(P>0.05)。结论羟考酮与氢吗啡酮镇痛方案较舒芬太尼方案具有更好的镇痛效果,可明显减轻胃癌患者术后疼痛,安全性较高。
Objective To evaluate the clinical efficacy and adverse effects of oxycodone,hydromorphone and sufentanil on postoperative analgesia in gastric cancer patients.Methods The gastric cancer patients who underwent radical surgery for gastric cancer in anesthesia analgesia system of the Fifth Affiliated Hospital of Sun Yat-sen University from June 1,2020 to June 31,2022 were retrieved.According to the postoperative analgesic plan,the patients were divided into hydromorphone group(n=108),oxycodone group(n=35)and sufentanil group(n=42).General baseline data such as age,gender,BMI,ASA classification,surgical approach,lymph node dissection,and postoperative complications were collected from all patients.Visual analogue scale(VAS)of rest and activity at 4-8 hours(T1),10-14 hours(T2),22-26 hours(T3),and 46-50 hours(T4),the number of presses of self-controlled analgesic pump and the incidence of postoperative adverse reactions were compared among the three groups.Results There was no statistically significant difference in general information among the three groups of patients(P>0.05).In the postoperative T1,T2,T3 and T4 moments,the analgesic effects of the oxycodone group and the hydromorphone group were better than those of the sufentanil group,with statistically significant differences(P<0.05);the analgesic effect of the oxycodone group and the hydromorphone group was the same(P>0.05).The total number of self-control presses of the analgesic pump in the oxycodone group and the hydromorphone group was less than that of the sufentanil group in 48 h(P<0.05);the total number of self-control presses of the analgesic pump in the oxycodone group was not significantly different from that of the hydromorphone group(P>0.05).In addition,there was no significant difference in the total incidence of adverse reactions among the three analgesic regimens(P>0.05).Conclusion Oxycodone and hydromorphone analgesic regimen have better analgesic effects than sufentanil regimen,which can significantly reduce postoperative pain in gastric cancer
作者
徐洪宇
何亚爽
Xu Hongyu;He Yashuang(Department of Anesthesiology,the Fifth Affiliated Hospital of Sun Yat-sen University,Zhuhai 519000,China)
出处
《中华消化病与影像杂志（电子版）》
2023年第5期312-316,共5页
Chinese Journal of Digestion and Medical Imageology(Electronic Edition)
关键词
胃癌
羟考酮
氢吗啡酮
胃癌根治术
镇痛
不良反应
Gastric cancer
Oxycodone
Hydromorphone
Radical surgery for gastric cancer
Analgesia
Adverse effects
