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| 无背景剂量羟考酮用于剖宫产术后静脉自控镇痛效果 |
| Effects of PCIA without background infusion of oxycodone in patients after cesarean section |
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| DOI：10.12089/jca.2020.07.011 |
| 中文关键词: 静脉自控镇痛 背景剂量 羟考酮 剖宫产术 |
| 英文关键词: Patient-controlled intravenous analgesia Background infusion Oxycodone Cesarean section |
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| 中文摘要: |
目的 探讨无背景剂量羟考酮在剖宫产术后静脉自控镇痛的效果。
方法 选择择期硬膜外麻醉下剖宫产手术产妇80例，年龄20~35岁，ASA Ⅰ或Ⅱ级，随机分为两组：无背景剂量羟考酮组（ON组）和有背景剂量羟考酮组（OY组），每组40例。胎儿娩出后，ON组和OY组均静脉缓慢注射羟考酮5 mg，关腹时连接静脉自控镇痛泵，镇痛药配方：ON组和OY组均为羟考酮45 mg+格拉司琼9 mg，均以生理盐水稀释至100 ml。OY组设置背景剂量2 ml/h，PCA剂量2 ml。ON组无背景剂量，PCA剂量4 ml。记录术后2、4、8、12、24 h的静息和活动时VAS评分、宫缩痛VAS评分以及Ramsay评分；记录术后下床时间、肛门排气时间和泌乳时间；记录24 h镇痛药累积消耗量；记录术后24 h内PICA按压次数和不良反应发生情况。
结果 ON组24 h镇痛药累积消耗量明显少于OY组[(24.6±9.7)mg vs (28.7±5.5)mg, P<0.05］。ON组术后24 h内PCIA按压次数多于OY组[(10.7±5.4) vs (7.8±6.1), P<0.05］。两组术后不同时点静息和活动时VAS评分、宫缩痛VAS评分和Ramsay评分差异无统计学意义。两组术后下床活动时间、肛门排气时间和泌乳时间差异无统计学意义。两组不良反应发生率差异无统计学意义。
结论 无背景剂量羟考酮自控镇痛用于剖宫产术后镇痛的效果与有背景剂量相似，但阿片类药物用量更少。 |
| 英文摘要: |
Objective To investigate the effect of oxycodone without background dose on patient-controlled intravenous analgesia (PCIA) after cesarean section.
Methods Eighty patients, aged 20-35 years, ASA Ⅰ or Ⅱ, scheduled for cesarean section, were randomly divided into two groups: oxycodone without background dose (group ON, n = 40) and oxycodone with background dose (group OY, n = 40). After delivery of the fetus, all patients received an intravenous dose of 5 mg oxycodone hydrochloride. After abdominal was closed, patients in both groups were given PCIA with 45 mg oxycodone, 9 mg granisetron and 0.9% saline in a volume of 100 ml. The parameters were set as background dose of 0 ml, single dose of 4 ml in group ON, and background dose of 2 ml, single dose of 2 ml in group OY. The VAS scores of uterine cramping pain and incision pain both at rest and during movement, and Ramsay sedation scores were recorded at 2, 4, 8, 12， 24 h after operation.Time of leaving bed, time of anal exhaust, colostrum time, and the cumulative consumption of analgesic drugs were recorded at 24 h; the number of PCIA pressing times and the occurrence of adverse reactions were recorded after operation.
Results The consumption of analgesics in group ON was less than that in group OY [(24.6 ± 9.7) mg vs (28.7 ± 5.5) mg] (P < 0.05). The number of PCIA boluses in group ON was more than that in group OY [(10.7 ± 5.4) vs (7.8 ± 6.1)] (P < 0.05). There was no significant difference in VAS scores of uterine cramping pain and incision pain at both rest and motion and Ramsay rating between the two groups. There was no significant difference in the time of leaving bed, anal exhaust and lactation between the two groups. There was no significant statistic difference in the incidence of adverse reactions between the two groups.
Conclusion Postoperative PCIA without background infusion of oxycodone can achieve a similar analgesic effect to PCIA with background infusion, but with less opioid use. |
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