文章摘要
不同剂量羟考酮预防肝切除术患者术后导尿管相关膀胱刺激征的效果
Effect of different dose oxycodone on preventing catheter-related bladder discomfort in hepatectomy
  
DOI：10.12089/jca.2019.09.009
中文关键词: 羟考酮  导尿管相关膀胱刺激征  肝切除术
英文关键词: Oxycodone  Catheter-related bladder discomfort  Hepatectomy
基金项目:湖南省自然科学基金项目(2018JJ3291)；长沙市科技计划项目(ZD1702026)
作者单位E-mail
赵媛 410005,长沙市,湖南省人民医院麻醉医学中心,湖南师范大学第一附属医院麻醉科  
孔高茵 410005,长沙市,湖南省人民医院麻醉医学中心,湖南师范大学第一附属医院麻醉科 konggaoyin@163.com 
裴万敏 410005,长沙市,湖南省人民医院麻醉医学中心,湖南师范大学第一附属医院麻醉科  
潘冰冰 410005,长沙市,湖南省人民医院麻醉医学中心,湖南师范大学第一附属医院麻醉科  
谭素红 410005,长沙市,湖南省人民医院麻醉医学中心,湖南师范大学第一附属医院麻醉科  
周柔 410005,长沙市,湖南省人民医院麻醉医学中心,湖南师范大学第一附属医院麻醉科  
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中文摘要:
      
目的 比较不同剂量羟考酮对肝切除手术患者麻醉恢复期导尿管相关膀胱刺激征(catheter-related bladder discomfort, CRBD)的预防效果。
方法 择期全麻下行开腹肝叶切除手术的男性患者120例,年龄18～60岁,BMI 20～27 kg/m2,ASA Ⅰ或Ⅱ级,随机分为三组,每组40例,术毕前30 min静推生理盐水5 ml(C组)、羟考酮0.1 mg/kg(O1组)或0.15 mg/kg(O2组)。记录苏醒时间和气管拔管时间,CRBD评分、VAS疼痛评分和不良反应。
结果 O1和O2组CRBD发生率分别为30.0％和27.5％,明显低于C组的52.5％(P<0.05)。O1和O2组中到重度CRBD的发生率均为5％,明显低于C组的25％(P<0.05)。与C组比较,拔管后O1组和O2组VAS评分明显降低(P<0.05),但O1组和O2组VAS评分差异无统计学意义。术后C组有4例恶心呕吐,O1组有1例恶心呕吐,O2组有1例寒战,三组不良反应发生率差异无统计学意义。
结论 术毕前30 min给予羟考酮0.1 mg/kg可降低开腹肝切除术后CRBD的发生率和严重程度,并有更好的镇痛效果。
英文摘要:
      
Objective To compare the effect of different dose of oxycodone on catheter-related bladder discomfort (CRBD) in the liver resection patients.
Methods A total of 120 male patients, aged 18-60 years, BMI 20-27 kg/m2, ASA physical status Ⅰ-Ⅱ, who underwent hepatectomy under general anesthesia were randomly divided into group C (nomal saline 5 ml), group O1 (0.1 mg/kg oxycodone) and group O2 (0.15 mg/kg oxycodone), all the drugs were injected 30 min before the end of surgery. Recovery time, tracheal extubation time, CRBD graded score and adverse reactions were recorded. VAS pain score at 0 min, 1 h, 2 h, 4 h after tracheal extubation were also recorded.
Results The incidence of CRBD in the groups O1 and O2 was 30.0％ and 27.5％, respectively, which was significantly lower than 52.5％ in group C (P < 0.05). The incidence of severe CRBD in the groups O1 and O2 was 5％, which was significantly lower than 25% in group C (P < 0.05). Compared with group C, the VAS scores of the groups O1 and O2 were significantly lower at each time point after extubation (P < 0.05). There was no significant difference in VAS score between the group O1 and group O2. There were 4 cases of nausea and vomiting in group C, 1 case of nausea and vomiting in group O1, and 1 case of chill in group O2. There was no significant difference in the incidence of adverse reactions between the three groups.
Conclusion The dose of 0.1 mg/kg oxycodone administered i.v. 30 min before the end of operation can decrease the incidence and severity of postoperative CRBD. And oxycodone better alleviates the pain.
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