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| 羟考酮或舒芬太尼预防瑞芬太尼诱发的术后痛觉过敏的效果 |
| Compariation of preventive effects of oxycodone or sufentanil on post-operative hyperalgesia induced by remifentail |
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| DOI： |
| 中文关键词: 羟考酮 瑞芬太尼 舒芬太尼 痛觉过敏 |
| 英文关键词: Oxycodone Remifentanil Sufentanil Hyperalgesia |
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| 中文摘要: |
| 目的 观察羟考酮或舒芬太尼预防瑞芬太尼术后痛觉过敏的作用。方法 全身麻醉下行择期胃癌根治术患者120例，男62例，女58例，年龄18～65岁，ASA Ⅰ或Ⅱ级。将患者随机分为三组:羟考酮组(O组，n=42)、舒芬太尼组(S组，n=40)和生理盐水组(C组，n=38)，术毕前分别给予羟考酮10 mg、舒芬太尼10 μg和等容量生理盐水。评价患者苏醒后静息VAS评分，若VAS≤3分则认为无痛觉过敏现象，＞3分为有痛觉过敏，≥6分则静注舒芬太尼，直至VAS评分<6分。记录拔除气管导管即刻(T1)、术后0.5 h(T2)、1 h(T3)、2 h(T4)和4 h(T5)的BCS舒适度评分，记录患者意识恢复时间、拔管时间及拔管后4 h内恶心呕吐的发生情况。结果 T1～T5时O组BCS评分明显高于S组和C组(P<0.05)。S组恶心呕吐发生率明显高于O组和C组(P<0.05)。三组意识恢复时间和拔管时间差异均无统计学意义。结论 术毕前静注羟考酮10 mg明显预防瑞芬太尼麻醉术后诱发的早期痛觉过敏，同时不影响患者苏醒，亦不增加恶心呕吐的发生率。 |
| 英文摘要: |
| Objective To compare the effect of oxycodone or sufentanil in preventing post-operative hyperalgesia induced by remifentanil. Methods One hundred and twenty patients scheduled for radical operation for carcinoma of stomach undergoing general anesthesia, 62 males and 58 females, aged 18-65 years, ASA physical status Ⅰ or Ⅱ, were randomly divided into 3 groups. Thirty minutes before the end of operation, oxycodone hydrochloride 10 mg was administered intravenously in oxycodone hydrochloride group (group O, n=42) while sufentanil 10 μg was injected in group S (group S, n=40) and equal normal saline was injected in control group (group C, n=38). The VAS score after waking up was recorded. VAS score＞3 was defined as hyperalgesia, and sufentanil was injected when VAS score≥6. The BCS scores were recorded immediately after extubation (T1), 30 min (T1), 1 h (T3), 2 h (T4) and 4 h (T5) after extubation. Awakening time and extubation time and the incidence of nausea and vomiting 4 h after extubation were compared. Results At T1-T5, the BCS scores in group O were significantly higher than those in groups S and C (P<0.05). Group S has a higher adverse reaction (P<0.05). There was no significant differences of awakening time and extubation time in 3 groups. Conclusion Prophylactic injection of oxycodone 10 mg can reduce incidence rate of post-operative hyperalgesia, and increase BCS score with little side effects. |
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