|
| 羟考酮对三叉神经微血管减压术患者术后早期恢复质量的影响 |
| Effect of oxycodone on early recovery after microvascular decompression on treating trigeminal neuralgia |
| |
| DOI： |
| 中文关键词: 羟考酮 舒芬太尼 三叉神经痛 微血管减压术 |
| 英文关键词: Oxycodone Sufentanil Trigeminal neuralgia Microvascular decompression |
| 基金项目:安徽省国际科技合作计划资助项目（1503062021） |
| 作者 | 单位 | | 翟明玉 | 230031,合肥市,安徽医科大学附属省立医院麻醉科 | | 黄祥 | 230031,合肥市,安徽医科大学附属省立医院麻醉科 | | 康芳 | 230031,合肥市,安徽医科大学附属省立医院麻醉科 | | 王洪涛 | 230031,合肥市,安徽医科大学附属省立医院麻醉科 | | 韩明明 | 230031,合肥市,安徽医科大学附属省立医院麻醉科 | | 李娟 | 230031,合肥市,安徽医科大学附属省立医院麻醉科 |
|
| 摘要点击次数: 2890 |
| 全文下载次数: 1772 |
| 中文摘要: |
| 目的 评价羟考酮在三叉神经微血管减压术患者中应用的安全性和有效性，并比较羟考酮与舒芬太尼对三叉神经微血管减压术患者术后早期恢复质量的影响。方法 选择择期行三叉神经微血管减压术患者86例，男38例，女48例，年龄18～65岁，BMI 18～30 kg/m2，ASA Ⅰ或Ⅱ级。采用随机数字表法将其分为两组:羟考酮组 (O组)和舒芬太尼组 (S组)，每组43例。两组均接受静-吸复合麻醉，麻醉诱导时O组静脉注射羟考酮0.3 mg/kg，S组静脉注射舒芬太尼0.4 μg/kg，在手术进行到关硬膜后即刻，O组静脉注射羟考酮0.07 mg/kg，S组静脉注射舒芬太尼0.1 μg/kg。于术前1 d、术后4、24和48 h采用数字评分法(numeric rating scale，NRS)评估患者手术切口疼痛和三叉神经区面部疼痛程度。当NRS评分≥4分时O组静脉注射羟考酮3 mg，S组静脉注射舒芬太尼5 μg进行补救镇痛。于术前1 d和术后3 d采用40项恢复质量评分量表 (QoR-40量表)评估患者恢复质量。记录术后补救镇痛情况、拔管时间、出院时间以及术后恶心呕吐、心动过缓、排尿困难、头晕和瘙痒的发生情况。结果 O组术后3 d的QoR-40量表评分中身体舒适度评分、情绪状态评分、心理支持评分、疼痛评分及总评分明显高于S组 (P<0.05)。O组术后恶心呕吐发生率明显低于S组 (20.9％ vs 37.2％) (P<0.05)。结论 在手术时间短于5 h的三叉神经微血管减压术患者中，羟考酮0.3 mg/kg可安全用于其麻醉诱导，羟考酮0.07 mg/kg及3 mg可分别安全有效地用于其预防性镇痛及补救镇痛;与舒芬太尼比较，羟考酮可提高三叉神经微血管减压术患者术后早期恢复质量，减少术后恶心呕吐。 |
| 英文摘要: |
| Objective To evaluate the efficacy and safety of oxycodone in patients undergoing microvascular decompression in treating trigeminal neuralgia and oxycodone versus sufentanil on early recovery after microvascular decompression in treating trigeminal neuralgia. Methods Eighty-six patients (38 males, 48 females, aged 18-65 years, BMI 18-30 kg/m2, ASA physical status Ⅰ or Ⅱ) scheduled for microvascular decompression in treating trigeminal neuralgia, were randomly divided into either oxycodone group (group O) and sufentanil group (group S) using a random number table, n=43 in each group. All patients received combined intravenous inhalational anesthesia, as well as oxycodone 0.3 mg/kg injected intravenously in group O, sufentanil 0.4 μg/kg injected intravenously in group S for anesthesia induced analgesia. When the epidural was closed, oxycodone 0.07 mg/kg was injected intravenously in group O, sufentanil 0.1 μg/kg was injected intravenously in group S. On preoperative day 1 and 4, 24, 48 hours after surgery, numeric rating scale (NRS) was used to assess the incision pain and facial pain. When NRS scores≥4, oxycodone 3 mg in group O and sufentanil 5 μg in group S was injected intravenously as rescue analgesic. On preoperative day 1 and 3 days after surgery, the global QoR-40 aggregating score was used to assess the quality of patients recovery. The requirement for rescue analgesics was recorded. The occurrences of nausea and vomiting were recorded. Extubation time and discharge were recorded. The other adverse events (bradycardia, dysuria, dizziness and pruritus) were recorded. Results Compared with group S, the physical comfort score, the emotional state score, the psychological support score, the pain score and the global QoR-40 scores were higher in group O 3 days after surgery (P<0.05). Compared with group S, the incidence of nausea and vomiting was significantly lower in group O (20.9% vs 37.2%) (P<0.05). Conclusion In surgery less than 5 hours of microvascular decompression on treating trigeminal neuralgia, oxycodone 0.3 mg/kg can be safely and effectively used for anesthesia induction, oxycodone 0.07 mg/kg and 3 mg can be respectively used for postoperative prophylactic analgesia and remedial analgesia. Compared with sufentanil, oxycodone can improve the quality of recovery during the early period after microvascular decompression on treating trigeminal neuralgia, and decrease the incidence of nausea and vomiting. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
