氨酚羟考酮胶囊在腰椎间盘突出症术前的超前镇痛作用

目的 观察氨酚羟考酮胶囊在腰椎间盘突出症（Lumbar disc herniation,LDH）术前的镇痛效果.方法 将70例择期行手术治疗的LDH患者随机分为2组,观察组35例,患者于术前8 h、90 min口服1粒氨酚羟考酮胶囊;对照组35例,患者术前30 min注射80 mg盐酸哌替啶.术后两组均进行硬膜外自控镇痛（PCEA）,观察两组镇痛效果.结果 观察组切皮时（T1）、神经根显露时（T2）、摘除突出髓核时（T3）、缝合切口时（T4）、术后2 h（T5）的VAS评分分别为（1.8±0.6）、（4.9±1.2）、（2.5±0.3）、（1.5±0.4）、（4.2±0.8）,均低于对照组的（2.3±0.4）、（6.5±1.3）、（3.2±0.6）、（2.2±0.5）、（5.4±0.7）,差异有统计学意义（P〈0.05或P〈0.01）;观察组术后盐酸哌替啶援助镇痛率及不良反应发生率分别为2.86%、8.57%,均低于对照组的22.86%、28.57%,差异有统计学意义（P〈0.05）.结论 氨酚羟考酮胶囊镇痛效果明显,用于LDH手术可延长术后镇痛时间,不良反应少,值得临床推广.

Effect of preemptive analgesic of oxycodone/paracetamol capsules on lumbar disc herniation

Objective To observe the preemptive analgesic effect of oxycodone/paracetamol capsules on LDH. Methods 70 patients with LDH undergoing elective surgery were randomly divided into two groups,35 patients in observation group were given oxycodone/paracetamol capsules at 8 h,90 min before operation, while 35 patients in control group were given 80 mg pethidine at 30 min before operation. Both groups were given implemented epidural an- algesia（PCEA） after operation. The analgesic effects of the two groups were observed. Results VAS in observation group at the time of skin incision （ T1 ） , appearance of nerve root （ T2 ） , extraction of lumbar （ T3 ） , suture of incision （T4）and2 h after operation（T5） were（1.8±0.6）,（4.9±1.2）,（2.5±0.3）,（1.5 ±0.4）,（4.2 ±0.8）,the indexes in control group were （ 2.3±0. 4 ） , （ 6. 5±1.3 ） , （ 3.2±0. 6 ） , （ 2. 2±0. 5 ） , （ 5.4± 0. 7 ） , there were significant differneces between the two groups（P 〈0. 01 ）. The analgesia pethidine hydrochloride assistance rate and incidence of adverse reactions in the observation group were lower than those of control group （2.86% vs. 22. 86% ,8.57% vs. 28.57 % , P 〈 0. 05 ）. Conclusion Oxycodone/paracetamol capsules has obvious analgesic effect,it can extend analgesia time for LDH surgery with fewer adverse reactions,it is worthy of promotion.