羟考酮在腹腔镜胆囊切除术麻醉中的效果及安全性
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四川省教育厅成果转化重大培育项目(15CZ0021);四川省卫生厅科研课题(100336)


Anesthetic efficacy of oxycodone in patients during laparoscopic cholecystectomy
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    摘要:

    【摘要】目的 探讨羟考酮用于腹腔镜胆囊切除术麻醉中的安全性和有效性。方法 选择行腹腔镜胆囊切除术的患者80例,随机分为对照组和观察组,每组各40例。对照组麻醉诱导时静脉注射舒芬太尼0.2μg/kg、丙泊酚2mg/kg与顺式阿曲库铵0.15mg/kg,观察组麻醉诱导时静脉注射羟考酮0.2mg/kg、丙泊酚2 mg/kg与顺式阿曲库铵0.15mg/kg。术中麻醉维持均采用丙泊酚联合瑞芬太尼靶控输注。记录两组患者术中瑞芬太尼和丙泊酚用量及麻醉时间、苏醒时间、拔管时间,记录拔管后1、4、8、12小时的 VAS评分及不良反应发生情况。于麻醉前、术后1、4、8小时测定血清中血糖和皮质醇水平。结果 两组患者术中瑞芬太尼和丙泊酚用量及麻醉时间、苏醒时间、拔管时间差异无统计学意义(P>0.05);观察组术后1、4小时的VAS评分、血糖和皮质醇水平明显低于对照组(P<0.05);两组出现苏醒期躁动、恶心呕吐、头晕、呼吸抑制发生率比较差异无统计学意义(P>0.05)。结论 羟考酮能安全有效的用于腹腔镜胆囊切除手术麻醉,且不良反应少,可在临床推广应用。

    Abstract:

    【Abstract】 Objective To observe the effect and safety of oxycodone in patients undergoing laparoscopic cholecystectomy. Methods 80 patients undergoing laparoscopic cholecystectomy were randomly divided into two groups, with 40 cases in each group. The control group was treated with sufentanil 0.2μg/kg + propofol 2mg/kg+ cisatracurium 0.15 mg/kg for anesthesia induction, while the observation group was treated with oxycodone 0.2mg/kg + propofol 2 mg/kg+ cisatracurium 0.15 mg/kg for anesthesia induction. Propofol targetcontrolled infusion combined with remifentanil were used for maintenance of general anesthesia during the operation. Total consumption of propofol and remifentanil, anesthesia time, awake time and extubation time were recorded. The adverse events and VAS score at 1h, 4h, 8h, and 12h after operation were observed. Glucose and serum cortisol were also measured before the operation and at 1h, 4h, 8h after the operation. Results There was no significant difference between groups in consumption of propofol and remifentanil and anesthesia time, awake time, extubation time. The VAS scores, glucose and serum cortisol at 1h,4h after operation of observation group were lower than that in control group(P<0.05). There was no significant difference between groups in the rate of complication. Conclusion Oxycodone can be used for laparoscopic cholecystectomy safely and effectively with less adverse reactions.

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  • 在线发布日期: 2019-05-23
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