摘要
目的探讨羟考酮镇痛对鼻内镜下鼻中隔矫正术患者苏醒期情况及术后疼痛的影响。方法选取2019年1月至2020年8月本院收治的鼻中隔偏曲患者123例,均行常规鼻内镜下鼻中隔矫正术。患者按随机数字表法分为羟考酮组(n=62)和芬太尼组(n=61)。两组均采用喉罩全凭静脉麻醉,芬太尼组麻醉诱导时予芬太尼0.2 mg/kg,手术结束前30 min予芬太尼0.5μg/kg;羟考酮组麻醉诱导时予羟考酮0.2 mg/kg,手术结束前30 min予羟考酮0.05 mg/kg。入手术室时(T0)、插管时(T1)、拔管结束时(T2)和出手术室时(T3)4个时点,记录两组患者平均动脉压(MAP)、心率。记录两组患者术后苏醒时间、拔管时间、麻醉恢复室(PACU)停留时间及苏醒期躁动评分。苏醒即刻、苏醒后30 min、苏醒后2 h、苏醒后4 h、苏醒后8 h,采用视觉模拟评分(VAS)评估两组患者的疼痛程度。记录术后1周内两组患者不良反应发生情况。结果T0时点两组MAP、心率差异均无统计学意义(均P>0.05),T1、T2、T3时点羟考酮组MAP、心率均显著低于芬太尼组(均P<0.05)。羟考酮组苏醒时间、拔管时间、PACU停留时间、苏醒期躁动评分均显著低于芬太尼组(均P<0.05)。苏醒后2 h、苏醒后4 h羟考酮组VAS评分均显著低于芬太尼组(均P<0.05)。羟考酮组术后不良反应发生率显著低于芬太尼组(24.19%比40.98%,χ^(2)=3.950,P=0.047)。结论鼻内镜下鼻中隔矫正术患者采用羟考酮镇痛,患者苏醒情况较好,术后疼痛减轻,不良反应发生率降低。
Objective To investigate the effect of oxycodone analgesia on the emergence characteristics and postoperative pain in patients undergoing endoscopic nasal septal correction.Methods A total of 123 patients with deviated nasal septum admitted to our hospital between January 2019 and August 2020 were included.All the patients underwent conventional endoscopic nasal septal correction while divided into the oxycodone group(n=62)and fentanyl group(n=61)according to random number table.The both groups were given total intravenous anesthesia with a laryngeal mask.The fentanyl group was given 0.2 mg/kg fentanyl during induction of anesthesia,and 0.5μg/kg fentanyl at 30 min before the end of surgery;the oxycodone group was given 0.2 mg/kg oxycodone during induction of anesthesia,and 0.05 mg/kg oxycodone at 30 min before the end of surgery.At 4 time points,i.e.at entering the operating room(T0),at intubation(T1),at extubation(T2),and at leaving the operating room(T3),the two groups were recorded for mean arterial pressure(MAP)and heart rate.The two groups were also recorded for postoperative time to awakening from anesthesia,time to extubation,duration of post-anesthesia care unit(PACU)stay and the score of emergence agitation.Immediately and at 30 min,2 h,4 h and 8 h after awakening,visual analog scale(VAS)was used to assess the pain in the two groups of patients.The incidence of adverse reactions in the two groups within one week after the surgery was recorded.Results There was no significant differences in MAP and heart rate between the two groups at T0(both P>0.05).The MAP and heart rate in the oxycodone group at T1,T2,and T3 were significantly lower than those in the fentanyl group(all P<0.05).The time to awakening from anesthesia,time to extubation,duration of PACU stay,and emergence agitation scores in the oxycodone group were significantly shorter or lower than those in the fentanyl group(all P<0.05).The VAS scores in the oxycodone group were significantly lower than those in the fentanyl group at 2 h and 4 h after awakening(both P<0.05).The incidence of adverse reactions in the oxycodone group was significantly lower than that in the fentanyl group(24.19%vs 40.98%,χ^(2)=3.950,P=0.047).Conclusion In patients undergoing endoscopic nasal septal correction,oxycodone analgesia may lead to favorable emergence characteristics,less postoperative pain and lower incidence of adverse reactions.
作者
刘婷玉
张美娟
梁轩
胡海立
Liu Tingyu;Zhang Meijuan;Liang Xuan;Hu Haili(Department of Anesthesiology,Beijing Tongren Hospital Affiliated to Capital Medical University,Beijing 100730,China)
出处
《中华生物医学工程杂志》
CAS
2021年第6期656-660,共5页
Chinese Journal of Biomedical Engineering
基金
北京市医院管理中心临床医学发展专项(ZYLX202103)。
关键词
羟考酮
芬太尼
鼻中隔矫正术
鼻内镜
苏醒期情况
疼痛
手术后
Oxycodone
Fentanyl
Nasal septal correction
Nasal endoscopy
Emergence characteristics
Pain,postoperative
