2019 年第 8 期 第 14 卷

盐酸羟考酮对开腹卵巢癌根治术患者全身麻醉苏醒期恢复质量的影响

Effect of oxycodone hydrochloride on general anesthesia recovery quality in patients undergoing laparotomy and radical ovarian cancer surgery

作者：董经纬赵国胜

英文作者：

单位：100026首都医科大学附属北京妇产医院麻醉科

英文单位：

关键词：卵巢癌根治术；羟考酮；全身麻醉苏醒期；恶心呕吐

英文关键词：

• 摘要：

• 【摘要】目的    观察盐酸羟考酮对开腹卵巢癌根治术患者全身麻醉苏醒期恢复质量的影响。方法    选取首都医科大学附属北京妇产医院2017年3月至2018年9月收治的100例行开腹卵巢癌根治术的患者，采用随机数字表法分为羟考酮组和舒芬太尼组，每组50例，麻醉诱导时及手术结束前20 min分别给予盐酸羟考酮0.1 mg/kg或舒芬太尼0.1 μg/kg。记录2组患者麻醉诱导前（T0）、术毕（T1）、拔管后5 min(T2)、拔管后30 min(T3)、拔管后1 h(T4)、拔管后2 h(T5)的收缩压、舒张压、心率、脉搏血氧饱和度(SpO2)。记录2组患者T2、T3、T4、T5的疼痛视觉模拟量表(VAS)评分和Ramsay镇静评分。记录2组患者拔管后不良反应的发生情况。结果    羟考酮组T1、T3时收缩压、舒张压、心率明显低于舒芬太尼组，T2时SpO2明显高于舒芬太尼组，差异均有统计学意义（均P＜0.05）。羟考酮组T3时VAS评分明显低于舒芬太尼组［（3.8±1.7）分比（5.9±2.0）分］,T2、T3时Ramsay镇静评分明显低于舒芬太尼组［(1.6±0.3)分比(3.5±0.4)分、(1.9±0.6)分比(3.2±0.5)分］，差异均有统计学意义（均P＜0.05）。羟考酮组苏醒期躁动、呼吸抑制、恶心和/或呕吐、寒战的发生率均明显低于舒芬太尼组（均P＜0.05）。结论    羟考酮用于开腹卵巢癌根治术患者可以产生良好的镇痛作用，维持术中血流动力学平稳，并减少术后恶心呕吐及躁动等不良反应的发生率，提高全身麻醉苏醒期的恢复质量。

• 【Abstract】Objective    To observe the effect of oxycodone hydrochloride on the recovery quality of general anesthesia in patients undergoing laparotomy and radical ovarian cancer surgery. Methods    A total of 100 patients undergoing laparotomy and ovarian cancer radical surgery between March 2017 to September 2018 in Beijing Obstetrics and Gynecology Hospital, Capital Medical University were randomly divided into oxycodone group and sufentanil group, with 50 cases in each group. The oxycodone group was administered 0.1 mg/kg oxycodone hydrochloride and the sulfentanyl group was administered 0.1 μg/kg sulfentanyl during anesthesia induction and 20 min before the end of surgery. Systolic blood pressure, diastolic blood pressure, heart rate and oxygen saturation of blood(SpO2) were recorded before induction(T0), after operation(T1), 5 min(T2), 30 min(T3), 1 h(T4) and 2 h(T5) after extubation. Visual Analogue Scale(VAS) and Ramsay sedation score were assessed at T2, T3, T4 and T5. Adverse reactions were observed after extubation. Results    Systolic blood pressure, diastolic blood pressure and heart rate at T1 and T3 were significantly lower and SpO2 at T2 was significantly higher in oxycodone group than those in sulfentanyl group（all P＜0.05）. VAS score at T3 in oxycodone group was significantly lower than that in sulfentanyl group［（3.8±1.7） vs （5.9±2.0）］; Ramsay sedation score at T2 and T3 in oxycodone group were significantly lower than those in sulfentanyl group［(1.6±0.3) vs (3.5±0.4), (1.9±0.6) vs (3.2±0.5)］（all P＜0.05）. Incidences of restlessness, respiratory depression, nausea and vomiting, shiver during recovery period in oxycodone group were significantly lower than those in sulfentanyl group（all P＜0.05）. Conclusion    Oxycodone has a good analgesic effect on patients undergoing laparotomy and radical ovarian cancer surgery; it can maintain stable hemodynamics, reduce postoperative nausea, vomiting and restlessness, and improve the recovery quality of anesthesia.