本文選題：羥考酮 + 腔鏡手術(shù)��； 參考：《廣東醫(yī)學(xué)》2017年S1期

【摘要】：目的觀察羥考酮注射液在腹腔鏡宮頸癌手術(shù)患者全麻蘇醒期的臨床鎮(zhèn)痛效果。方法選擇擇期全麻下進(jìn)行腹腔鏡宮頸癌手術(shù)的女性患者60例,年齡48~65歲。采用隨機(jī)數(shù)表法將其隨機(jī)分為兩組:羥考酮組(Q組,n=30),芬太尼組(F組,n=30)。常規(guī)麻醉誘導(dǎo)后,用七氟醚、丙泊酚和瑞芬太尼進(jìn)行術(shù)中維持,手術(shù)結(jié)束前30 min分別給予羥考酮(Q組)0.1 mg/kg、芬太尼(F組)1.5μg/kg。術(shù)畢送到恢復(fù)室(PACU)進(jìn)行復(fù)蘇,記錄患者的手術(shù)時(shí)間和麻醉時(shí)間,進(jìn)入復(fù)蘇室后自主呼吸恢復(fù)時(shí)間、蘇醒時(shí)間以及拔管時(shí)間,記錄患者入復(fù)蘇室(T_0)拔管時(shí)(T_1)、拔管后5(T_2)、15 min(T_3)的各時(shí)點(diǎn)視覺模擬評分(VAS)和鎮(zhèn)靜評分(Ramsay),記錄患者蘇醒期出現(xiàn)的不良反應(yīng)。結(jié)果兩組患者麻醉時(shí)間及手術(shù)時(shí)間比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。Q組患者自主呼吸恢復(fù)時(shí)間、拔管時(shí)間及蘇醒時(shí)間均較F組短,差異有統(tǒng)計(jì)學(xué)意義(P0.05);Q組在T_3時(shí)VAS評分明顯低于F組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),Q組在的Ramsay評分在T_0、T_1、T_2時(shí)間點(diǎn)均明顯低于F組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論鹽酸羥考酮注射液應(yīng)用于腹腔鏡宮頸癌手術(shù)患者全麻蘇醒期是有效的,0.1 mg/kg能夠提供有效的鎮(zhèn)痛,有利于維持患者蘇醒期的血流動(dòng)力學(xué)穩(wěn)定,保護(hù)患者全麻蘇醒期的安全。
[Abstract]:Objective to observe the analgesic effect of hydroxycodone injection in patients undergoing laparoscopic cervical cancer surgery during general anesthesia recovery. Methods A total of 60 female patients with cervical cancer undergoing laparoscopic surgery under general anesthesia were selected, aged 4865 years. The rats were randomly divided into two groups by random number table: group Q with hydroxycodone and group F with fentanyl. After routine anesthesia induction, sevoflurane, propofol and remifentanil were used for intraoperative maintenance. At 30 min before the end of operation, hydroxycodone Q group (0.1 mg / kg) and fentanyl F group (1.5 渭 g / kg) were given respectively. The operation time and anesthesia time, the time of spontaneous respiration recovery, recovery time and extubation time after entering the resuscitation room were recorded. The visual analogue scores (VASS) and sedation scores (Ramsayi) were recorded at each time point after the extubation and 5 minutes after the extubation. The adverse reactions in the recovery period were recorded. Results there was no significant difference in anesthesia time and operation time between the two groups. The time of spontaneous respiratory recovery, extubation and recovery time in group Q were shorter than those in group F, and the VAS scores in group P 0.05 and Q were significantly lower than those in group F at T3. The Ramsay score of group Q was significantly lower than that of group F (P 0.05). Conclusion hydroxycodone hydrochloride injection is an effective analgesia for patients undergoing laparoscopic cervical cancer surgery during general anesthesia recovery. It is helpful to maintain hemodynamic stability and protect the safety of patients during general anesthesia recovery.
【作者單位】： 杭州市中醫(yī)院麻醉科;華北理工大學(xué)附屬唐山市人民醫(yī)院麻醉科;
【分類號(hào)】：R614;R737.33

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