不同剂量羟考酮应用于经腹子宫肌瘤剔除术的镇痛效果及对病人应激反应的影响

目的探究不同剂量羟考酮应用于经腹子宫肌瘤剔除术的镇痛效果及对病人应激反应的影响。方法选取行经腹子宫肌瘤剔除术的128例病人作为研究对象，按羟考酮的给予量分为4组，每组32例，其中，A、B、C组分别给予0.05、0.10、0.15 mg/kg羟考酮，O组给予芬太尼0.001 mg/kg。比较4组病人疼痛视觉模拟量表（VAS）、躁动-镇静量表（RASS）评分、血糖、皮质醇水平及不良反应发生率。结果A组T2和T4、B组T2和T3及C组T2~T4时病人VAS评分均较T1时降低（P < 0.05~P < 0.01），A组、B组、C组和O组T2~T4的RASS评分均较T1时明显升高（P < 0.01）。A组、B组、C组T1和T2时病人的VAS评分均明显低于O组（P < 0.01），A组、B组、C组T1时病人的RASS评分均明显低于O组（P < 0.01）；B组、C组T1~T3时病人的VAS评分均明显低于A组（P < 0.01），C组T1时病人的RASS评分明显低于A组（P < 0.01）；C组T1时病人的VAS、RASS评分低于B组（P < 0.05和P < 0.01）。A组T2~T4、B组T2和T4及O组T1~T4时病人血糖水平均较T0时升高（P < 0.05~P < 0.01），A组、B组、C组和O组T1~T4时病人的皮质醇水平均较T0时明显升高（P < 0.01）。A组、B组、C组T1~T3时病人的血糖和皮质醇水平均低于O组（P < 0.05~P < 0.01）。C组总不良反应发生率高于其他3组（P < 0.05）。结论应用剂量为0.10 mg/kg的羟考酮对于行经腹子宫肌瘤剔除术病人的镇痛效果好、安全性高，并且能显著抑制病人应激反应，值得推广使用。

Analgesic effects of different doses of oxycodone in transabdominal myomectomy and its effect on stress response of patients

ObjectiveTo explore the analgesic effects of different doses of oxycodone on transabdominal myomectomy and its effect on stress response.MethodsOne hundred and twenty-eight patients with transabdominal myomectomy were divided into the group A(treated with 0.05 mg/kg of oxycodone), group B(treated with 0.10 mg/kg of oxycodone), group C(treated with 0.15 mg/kg of oxycodone)and group O(treated with 0.001 mg/kg of fentanyl)according to the dose of oxycodone(32 cases in each group).The visual analogue scale(VAS)score, restlessness and sedation scale(RASS)score, blood glucose and cortisol levels, and incidence rate of adverse reactions were compared among 4 groups.ResultsThe VAS scores of group A at T2 and T4, group B at T2 and T3, and group C at T2 to T4 were lower than those of three groups at T1(P < 0.05 to P < 0.01).The RASS scores of group A, group B, group C and group O at T2 to T4 were significantly increased compared with those at T1(P < 0.01).The VAS scores in group A, group B and group C at T1 and T2 were significantly lower than those in group O(P < 0.01), and the RASS scores in group A, group B and group C at T1 were significantly lower than those in group O(P < 0.01).The VAS scores in group B and group C at T1 to T3 were significantly lower than those in group A(P < 0.01), and the RASS score in group C at T1 was significantly lower than that in group A(P < 0.01).The VAS and RASS scores in group C at T1 were lower than those in B group(P < 0.05 and P < 0.01).The blood glucose levels in group A at T2 to T4, group B at T2 to T4 and group O at T1 to T4 were significantly higher than those at T0(P < 0.05 to P < 0.01).The levels of cortisol in A, B, C and O groups at T1 to T4 significantly increased compared with at T0(P < 0.01).The blood glucose and cortisol levels in group A, group B and group C at T1 to T3 were lower than those in group O(P < 0.05 to P < 0.01).The incidence rate of total adverse reactions in group C was higher than that in other 3 groups(P < 0.05).ConclusionsThe 0.10 mg/kg of oxycodone in transabdominal myomectomy has good analgesic effect, high safety, and can significantly inhibit the stress response of patients.It is worthy of popularization.