盐酸羟考酮注射液超前镇痛对乳腺癌改良根治术术后镇痛的影响

目的] 探讨盐酸羟考酮注射液超前镇痛对乳腺癌改良根治术术后镇痛的影响.方法] 选择ASAⅠ~Ⅱ级择期于全麻下行乳腺癌改良根治术患者90例,随机分为A、B、C三组,每组30例.于麻醉诱导前10 min,A组静注盐酸羟考酮0.1 mg/kg,B、C两组静注生理盐水10 mL;手术停止时三组患者给予自控静脉镇痛泵(PCIA),A、B两组均为舒芬太尼1.0 μg/(kg·100 mL),C组为舒芬太尼2.0 μg/(kg·100 mL),三组PCIA背景剂量均为2 mL/h,病人自控剂量为3 mL,锁时时间为15 min,三组患者其他用药相同. 采用VAS疼痛评分在术后2 h、8 h、24 h、48 h对患者的镇痛效果进行评价并观察患者有无恶心、呕吐、头晕等不良反应. 结果] 三组患者的苏醒与拔管时间相比较差异无显著性(P>0.05);A、C两组VAS评分显著低于B组(P<0.05);A、C两组VAS评分差异无显著性(P>0.05);A、B两组不良反应发生率低于C组(P<0.05),A、B两组之间差异无显著性(P>0.05).结论] 盐酸羟考酮能安全有效的用于乳腺癌改良根治术患者的超前镇痛,不影响苏醒和拔管时间,并可以减少PCIA舒芬太尼的用量从而降低术后镇痛不良反应的发生率.

Effects of Oxycodone Injection as Preemptive Analgesia on Postoperative Analgesia in Breast Cancer Patients after Modified Radical Mastectomy

Objective]To explore the postoperative analgesia effect of oxycodone injection as preemptive analgesia in patients who underwent patient-controlled intravenous analgesia (PCIA) after modified radical mastectomy.Methods]Ninety patients with breast cancer (ASA Ⅰ~Ⅱ) who were scheduled for modified radical mastectomy and required PCIA were randomly divided into 3 groups, A、B and C, with 30 cases in each group.Patients in A group received the preemptive analgesia with oxycodone (0.1mg/kg) 10 minutes before anesthesia induction, while patients in B and C groups received intravenous injection of saline (10mL).After surgery, all patient received PCIA with different concentrations of sufentanil,A and B group received sufentanil 1.0 μg/(kg·100 mL) while C group received sufentanil 2.0 μg/(kg·100 mL)].PCIA settings were: background infusion dose at 2 mL/h, patient-controlled dose of 3mL, and lockout interval for 15 minutes.Other drugs were the same in each group.Each patient's awakening and extubation time, the VAS at 2h, 12h, 24h, and 48h postoperation and adverse events (nausea, vomiting and dizziness) were observed and recorded.Results]There were no statistical significance in awakening and extubation times among the three groups(P>0.05).Compared with the patients in B group, the patients' VAS in A and C groups were significantly lower(P<0.05).However, there was no statistically significant difference between the A and C groups(P>0.05).Compared with the patients in the C group, the numbers of adverse events in A and B groups were significantly lower(P<0.05), but there was no statistically significant difference between A and B groups(P>0.05).Conclusion]Preemptive analgesia with oxycodone injection can be effectively and safely used in patients undergoing modified radical mastectomy.It has no effect on patient's awakening and extubation time and can lower the total dosage of sufentanil given, which reduces the incidence of adverse reactions.