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| 预注羟考酮与舒芬太尼在经肝动脉化疗栓塞术中镇痛效果的比较 |
| Comparison of a single dose of preventive oxycodone and sufentanil on pain during transcatheter arterial chemoembolization |
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| DOI：10.12089/jca.2024.12.006 |
| 中文关键词: 羟考酮 舒芬太尼 经肝动脉化疗栓塞术 镇痛 |
| 英文关键词: Oxycodone Sufentanil Transcatheter arterial chemoembolization Analgesia |
| 基金项目:国家自然科学基金青年项目（81901855） |
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| 中文摘要: |
目的：比较预注羟考酮与舒芬太尼在经肝动脉化疗栓塞（TACE）术中的镇痛效果及其不良反应。
方法：选择择期局部浸润麻醉下行TACE的患者40例，男37例，女3例，年龄33~81岁，BMI 18.5~30.0 kg/m 2，ASA Ⅰ或Ⅱ级。将患者随机分为两组：羟考酮组（O组）和舒芬太尼组（S组），每组20例。术前15 min，O组静脉注射羟考酮0.1 mg/kg；S组静脉注射舒芬太尼0.1 μg/kg。记录术中最高VAS疼痛评分，即栓塞即刻、栓塞后5、30 min的VAS疼痛评分中的最高值。记录术后1、6、12、24 h的VAS疼痛评分和上述时点疼痛程度。记录围术期补救镇痛情况，介入医师满意度评分，术前10 min、栓塞后5 min、术后10 min的HR和MAP，恶心、呕吐、头晕、嗜睡、便秘和排尿困难等不良反应的发生情况。
结果：与S组比较，O组术中最高VAS疼痛评分明显降低（P<0.01），术中无痛率更高（P<0.05），中度疼痛发生率明显降低（P<0.05）。术后1、6、12、24 h两组VAS疼痛评分和疼痛程度差异无统计学意义。与S组比较，O组围术期补救镇痛率明显降低（P<0.01），介入医师满意度评分明显升高（P<0.05），栓塞后5 min MAP明显降低（P<0.05）。两组围术期不良反应差异无统计学意义。两组无一例呼吸抑制发生。
结论：TACE术前预注单剂量羟考酮，其术中镇痛效果明显优于等效剂量的舒芬太尼。 |
| 英文摘要: |
Objective: To compare the analgesic effects and adverse events of oxycodone and sufentanil in transcatheter arterial chemoembolization (TACE).
Methods: Forty patients who underwent selective TACE under local infiltration anesthesia were enrolled in this study, 37 males and 3 females, aged 33-81 years, BMI 18.5-30.0 kg/m 2, ASA physical status Ⅰ or Ⅱ. The patients were randomly divided into two groups: the oxycodone group (group O) and the sufentanil group (group S), 20 patients in each group. Patients in group O and group S received a single injection of oxycodone 0.1 mg/kg and sufentanil 0.1 μg/kg respectively, 15 minutes before TACE. Visual analogue scale (VAS) was performed during the operation and at 1 hour, 6, 12, and 24 hours after TACE. Pain severity was recorded at each time point. The highest intraoperative pain scores were recorded during the three time points, at immediately after embolization, 5 minutes after embolization, and 30 minutes after embolization. Need for rescue analgesics, interventional physician satisfaction score, HR and MAP 10 minutes before surgery, 5 minutes after embolization, and 10 minutes after surgery,as well as the occurrence of adverse events such as nausea, vomiting, dizziness, drowsiness, constipation, and dysuria were recorded.
Results: Compared with group S, the highest intraoperative VAS pain score was lower (P < 0.01), the incidence of intraoperative painless was higher (P < 0.05), and the incidence of intraoperative moderate pain was significantly lower in group O (P < 0.05). There were no significant differences in VAS pain score and pain severity between the two groups 1 hour, 6, 12, and 24 hours after TACE. Compared with group S, the incidence of perioperative rescue analgesia in group O was significantly lower (P < 0.01), the interventional physician reported higher degree of satisfaction, MAP was significantly decreased 5 minutes after embolization (P < 0.05). There was no statistically significant difference in perioperative adverse events between the two groups. None of the patients in the two groups had respiratory depression.
Conclusion: A single dose of preventive oxycodone is superior to sufentanil for TACE-related intraoperative pain control. |
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