摘要
目的观察羟考酮术前给药对腹腔镜胆囊切除术（LC）后疼痛及炎性细胞因子的影响。方法 80例择期行LC患者,男45例,女35例,年龄38~60岁,ASAⅠ或Ⅱ级。按随机数字表法分为四组,每组20例,分别于手术开始前10min静脉注射：O1组羟考酮0.1mg/kg、O2组羟考酮0.15mg/kg、O3组羟考酮0.2 mg/kg（各组药物稀释至2 ml）、C组生理盐水2 ml。采用VAS评分和Ramsay镇静评分对患者术后1、2、4、8、12、24h进行疼痛和镇静程度评分,于麻醉前、术后4、12、24h测定血清中IL-6和IL-10水平,并记录不良反应发生情况。结果 O1组在术后1、2h,O2组和O3组在术后1、2、4、8h的VAS评分明显低于C组（P〈0.05）;O2组和O3组在术后1、2、4、8h的VAS评分明显低于O1组（P〈0.05）。O3组在术后1、2、4h的Ramsay评分明显高于O1组、O2组和C组（P〈0.05）;O1组和O2组术后1h的Ramsay评分明显高于C组（P〈0.05）。与麻醉前比较,术后4、12、24h四组IL-6和IL-10水平明显升高（P〈0.05）。O1组、O2组和O3组术后4、12hIL-6水平明显低于C组,术后4、12、24hIL-10水平明显高于C组（P〈0.05）。O3组嗜睡、头晕、恶心呕吐的发生率明显高于O1组、O2组和C组（P〈0.05）。结论 LC术前静脉注射羟考酮0.15mg/kg可有效缓解术后疼痛且不良反应少,同时能调节细胞因子水平,维持促炎与抗炎细胞因子平衡。
Objective To investigate the impact of different doses of oxycodone administration preoperatively on postoperative pain and inflammatory cytokines in patients undergoing laparoscopic cholecystectomy（LC）.Methods Eighty patients（male 45 cases,female 35 cases,aged 38-60 years,ASA Ⅰ or Ⅱ grade）scheduled for laparoscopic cholecystectomy were randomly divided into four groups（n=20）：0.1mg/kg,0.15mg/kg,0.2mg/kg oxycodone or 2ml normal saline were administered intravenously ten minutes before operation in Groups O1,O2,O3,and group C,respectively.Visual analogue scale（VAS）pain score and Ramsay sedation score were measured on 1,2,4,8,12 and 24hpostoperatively.Serum IL-6and IL-10 levels were measured before the operation and on time points of 4,12 and 24hafter the operation.Adverse effects were also recorded.Results Compared with group C,VAS of group O1 was lower within 2hours postoperatively.VAS of group O2,O3 were also lower at 1,2,4,8hpostoperatively（P〈0.05）.Compared with group O1,VAS of group O2 and O3 were lower at 1,2,4,8hpostoperatively（P〈0.05）.Ramsay score of group O3 was higher than other groups at 1,2,4hpostoperatively,（P〈0.05）.Compared with group C,Ramsay scores of group O1 and O2 were higher at 1hour postoperatively,（P〈0.05）.Serum IL-6and IL-10 concentration of the four groups increased at 4,12,and 24 hafter surgery（P〈0.05）.Compared with group C,serum IL-6concentration decreased significantly within 4,12 hof group O1,O2,O3（P〈0.05）postoperatively and serum IL-10 concentration increased significantly within 4,12,24hpostoperatively（P〈0.05）.The incidences of somnolence,dizziness,nausea and vomiting were higher in group O3 than that of other groups（P〈0.05）.Conclusion 0.15mg/kg oxycodone administration preoperatively may relieve postoperative pain effectively in LC patients with lessadverse effects.It can also effectively adjust cytokine concentration and maintain the equilibrium of inflammatory and anti-inflammatory cytokine.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2015年第10期941-944,共4页
Journal of Clinical Anesthesiology
基金
南京市溧水区科技局资助项目(编号20140135)
