摘要
目的:探讨羟考酮联合吗啡在老年腹部手术患者术后自控静脉镇痛(patient controlled intravenous analgesia,PCIA)的镇痛效果。方法:回顾性分析2020年3月至2021年11月无锡市第九人民医院收治112例老年腹部手术患者的围手术期资料,依据术后PCIA镇痛方案不同,分成羟考酮组52例与联合组(吗啡+羟考酮)60例。比较两组术后静息和咳嗽状态下视觉模拟评分(Visual Analogue Score,VAS)、Ramsay镇静评分满意率、PCIA使用情况和麻醉不良反应情况。结果:静息状态下,联合组术后12、24 h的VAS评分低于羟考酮组(P<0.05);咳嗽状态下,联合组术后12、24、48 h的VAS评分低于羟考酮组(P<0.05)。两组术后12~48 h的镇静满意率比较差异不显著(P>0.05)。联合组术后48h阿片类药物使用量、PCIA实际按压和有效按压次数均少于羟考酮组(P<0.05)。联合组麻醉不良反应率6.67%低于羟考酮组19.23%(P<0.05)。结论:羟考酮联合吗啡用于老年腹部手术患者术后PCIA的镇痛效果显著,能减少阿片类药物使用量和降低麻醉不良反应发生率,尤其适合老年人术后PCIA。
Objective:To investigate the analgesic effect of oxycodone combined with morphine on postoperative patient-controlled intravenous analgesia(PCIA)in elderly patients undergoing abdominal surgery.Methods:The perioperative data of 112 elderly patients undergoing abdominal surgery at Wuxi Ninth People’s Hospital from March 2020 to November 2021 were analyzed retrospectively.According to different postoperative PCIA analgesia schemes,they were divided into oxycodone group(52 cases)and combined group(morphine+oxycodone)(60 cases).The Visual Analogue Score(VAS),Ramsay sedation score satisfaction rate,PCIA usage and adverse anesthetic reactions were compared between the 2 groups.Results:At rest,the VAS scores at 12 and 24 h in the combined group were lower than those in the oxycodone group(P<0.05).In cough state,the VAS score of the combined group at 12,24,and 48 h after operation was lower than that of the oxycodone group(P<0.05).There was no significant difference in sedation satisfaction rate between the 2 groups 12-48 h after operation(P>0.05).The use of opioids,the actual press and effective press times of PCIA in the combined group were less than those in the oxycodone group 48 h after operation(P<0.05).The adverse reaction rate of anesthesia in the combined group was 6.67%lower than 19.23%in the oxycodone group(P<0.05).Conclusion:Oxycodone combined with morphine has a significant analgesic effect on postoperative PCIA in elderly patients undergoing abdominal surgery.It can reduce the use of opioids and reduce the incidence of adverse anesthetic reactions,especially for postoperative PCIA in the elderly.
作者
顾宇杰
GU Yujie(Department of Anesthesiology,Wuxi Ninth People’s Hospital,Wuxi Jiangsu 214000,China)
出处
《临床与病理杂志》
CAS
2022年第9期2187-2192,共6页
Journal of Clinical and Pathological Research
关键词
腹部手术
自控静脉镇痛
阿片类药物
羟考酮
吗啡
镇痛效果
不良反应
abdominal surgery
patient controlled intravenous analgesia
opioids
oxycodone
morphine
analgesic effect
adverse reaction
