不同剂量羟考酮复合丙泊酚对宫腔镜手术的麻醉效果

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1252 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的：比较宫腔镜手术不同剂量羟考酮复合丙泊酚的麻醉效果，探讨羟考酮的适宜剂量。方法：择期行宫腔镜手术患者60例，随机分为4组（n=15）：羟考酮复合丙泊酚3组（O1组、O2组、O3组）和单纯丙泊酚组（P组），O1、O2和O3组分别静脉注射羟考酮0.05、0.10、0.15 mg/kg，P组静脉注射0.9%氯化钠溶液
0.15 mL/kg；随后每组均注射丙泊酚至无反应后行宫腔镜手术，丙泊酚持续输注至退出宫腔镜时停药。记录各时点收缩压（SBP）、舒张压（DBP）、心率（HR）和经皮脉搏氧饱和度（SpO2）。记录丙泊酚诱导量、维持量、总用药量、总用药时间、单位时间用量。记录手术时间、麻醉苏醒时间、离院时间、术中术后不良反应发生比例和苏醒时VAS评分。结果：4组手术时间、丙泊酚维持量及低血压、心动过缓、体动反应、恶心呕吐发生比例的差异无统计学意义（P＞0.05）。与P组比较，O2、O3组丙泊酚诱导量、单位时间用量及VAS评分下降；O1、O2和O3组苏醒时间缩短；O3组头晕发生比例升高（均P＜0.05）。与O1组比较，O2、O3组丙泊酚诱导量、单位时间用量下降，苏醒时间缩短；O3组VAS评分下降（均P＜0.05）。与O2组比较，O3组丙泊酚诱导量下降（P＜0.05）。与P、O1和O2组比较，O3组SpO2下降发生比例升高，离院时间延长（P＜0.05）。结论：宫腔镜手术羟考酮配伍丙泊酚的适宜剂量是0.1 mg/kg。

	服务
	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	缪项慧
	李和
	姜辉
	吴艳琴
	林函

关键词 ： , 羟可酮；丙泊酚；宫腔镜

Abstract：Objective: To compare the efficacy of different doses of oxycodone combined with propofol and explore the appropriate dose of oxycodone for hysteroscopy. Methods: Sixty patients who were scheduled for hysteroscopy were randomly divided into 4 groups (n=15 each): three oxycodone plus propofol groups (group O1, group O2, group O3) and propofol group (group P). In Groups O1, O2 and O3, oxycodone 0.05, 0.1, 0.15 mg/kg were injected respectively. Normal saline 0.15 mL/kg was bolused in Group P. Subsequentlythe hysteroscope was inserted until loss of response with intravenous administration of propofol, followed by a continuous infusion of propofol until the withdrawal of hysteroscope. At each time point, SBP, DBP, HR, and SpO2 were recorded. Propofol induced dosage, maintenance dosage, total dosage, total propofol administration time, the consumption of propofol per minute, operation time, emergence time, discharge time, the incidence of adverse reactions during intraoperative and postoperative and VAS scores were recorded. Results: There was no significant difference in the operation time, maintenance dosage and the incidence of hypotension, bradycardia, body movement, and nausea and vomiting between the four groups. Compared with group P, propofol induced dosage, the consumption of propofol per minute and VAS scores were significantly decreased in groups O2 and O3, emergence time was significantly decreased in groups O1, O2 and O3, and the incidence of dizziness was significantly increased in group O3 (P<0.05). Compared with group O1, propofol induced dosage, the consumption of propofol per minute and emergence time were significantly decreased in groups O2 and O3, and VAS scores was significantly decreased in group O3 (P<0.05). Propofol induced dosage was lower in group O3 than that in group O2 (P<0.05). The incidence of oxygen desaturation was higher and discharge time was longer in group O3 than that in groups P, O1 and O2 (P<0.05). Conclusion: The optimum dose of oxycodone is 0.1 mg/kg when combined with propofol for hysteroscopy.

Key words： oxycodone propofol hysteroscopy

收稿日期: 2017-03-28

基金资助:温州市卫生局双鹰人才计划资助项目（2014SY2009038）。

通讯作者: 林函，主任医生，Email：nanlinhannansh@qq.com

作者简介: 缪项慧（1985-），女，浙江温州人，主治医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2017/V47/I10/748

[1].DAVIS M P, GOFORTH H W. Oxycodone with an opioid receptor antagonist: A review[J]. J Opioid Manag, 2016, 12 (1): 67-85.
[2].ROSA P, FEDERICA M, ANNAMARIA V, et al. Combined administration of oxycodone/naloxone in chronic osteo-articular diseases pain therapy[J]. Transl Med UniSa, 2014, 24 (9): 38-42.
[3].FANELLI G, FANELLI A. Developments in managing severe chronic pain: role of oxycodone-naloxone extended re-lease[J]. Drug Des Devel Ther, 2015, 22(9): 3811-3816.
[4].LEVY O, AMIT-VAZINA M, SEGAL R, et al. Visual analogue scales of pain, fatigue and function in patients with various rheumatic disorders receiving standard care[J]. Isr Med Assoc J, 2015, 17(11): 691-696.
[5]. KOKKI H, KOKKI M, SJOVALL S. Oxycodone for the treatment of postoperative pain[J]. Expert Opin pharmacother, 2012, 13(7): 1045-1058.
[6]. 徐建国. 盐酸羟考酮的药理学和临床应用[J]. 临床麻醉学杂志, 2014, 30(5): 511-513.
[7]. ELLIOTT P, O’HARE R, BILL K M, et al. Severe cardiovascular depression with remifentanil[J]. Anesth Analg, 2000, 91(1): 58-61.
[8]. DIETERICH M, MÜLLER-JORDAN K, STUBERT J, et al. Pain management after cesarean: a randomized controlled trial of oxycodone versus intravenous piritramide[J]. Arch Gynecol Obstet, 2012, 286(4): 859-865.
[9].PEDERSEN K V, OLESEN A E, DREWES A M, et al. Morphine versus oxycodone analgesia after percutaneous kidney stone surgery: a randomised double blinded study[J]. Urolithiasis, 2013, 41(5): 423-430.
[10].YILMAZ H, ARUN O, APILIOGULLARI S. et al. Effect of laparoscopic cholecystectomy techniques on postoperative pain: a prospective randomized study[J]. J Korean Surg Soc, 2013, 85(4): 149-153.
[11].AMRI A, BEN ACHOUR A, CHACHATY E, et al. Microbiological and physicochemical stability of oxycodone hydrochloride solutions for patient-controlled delivery systems[J]. J Pain Symptom Manage, 2010, 40(1): 87-94.
[12].PARK J H, LEE C, SHIN Y, et al. Comparison of oxycodone and fentanyl for postoperative patient-controlled analgesia after laparoscopic gynecological surgery[J]. Korean J Anesthesiol, 2015, 68(2): 153-158.