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超前静脉注射羟考酮对鞘内注射舒芬太尼的低剂量布比卡因腰麻的影响。

Effect of preemptive intravenous oxycodone on low-dose bupivacaine spinal anesthesia with intrathecal sufentanil.

作者信息

Wang Jinguo, Pang Lei, Han Wei, Li Guohua, Wang Na

机构信息

Department of Urology, the First Hospital of Jilin University, Changchun, Jilin, China. E-mail.

出版信息

Saudi Med J. 2015 Apr;36(4):437-41. doi: 10.15537/smj.2015.4.10706.

Abstract

OBJECTIVES

To evaluate the efficacy of preemptive intravenous oxycodone on low-dose bupivacaine spinal anesthesia with intrathecal sufentanil in patients undergoing transurethral resection of the prostate (TURP).

METHODS

In this randomized, double-blinded, placebo-controlled trial, 60 patients undergoing TURP were allocated into 2 groups: oxycodone group (group O, n=30) and a normal saline group (group N, n=30). Oxycodone 0.1 mg/kg, or normal saline 0.1 ml/kg was administered intravenously 10 minutes before surgical procedures in group O, or in group N. All patients received sufentanil 5 µg + bupivacaine 0.5% (0.8 ml) + normal saline 0.7 ml - in total, bupivacaine 0.25% (1.6 ml) intrathecally. Spinal block characteristics, hemodynamic values, the perioperative analgesic requirements, visual analogue scale (VAS) scores, Ramsay sedation scale, and side effects were assessed. The study was carried out at the First Hospital of Jilin University, Jilin, China between March and September 2014.

RESULTS

The time to 2-segment regression of sensory block, full recovery of sensory block, and first analgesic request was longer in group O. Fewer patients required postoperative analgesics, and the VAS pain scores at 4, 8, 16, and 24 hour after operation were significantly lower in group O.

CONCLUSION

Preemptive intravenous oxycodone was an efficient and safe method to decrease postoperative pain and reduce tramadol analgesia in patients under low-dose dilute bupivacaine spinal anesthesia combined with intrathecal sufentanil.

摘要

目的

评估预先静脉注射羟考酮对接受经尿道前列腺切除术(TURP)患者低剂量布比卡因蛛网膜下腔麻醉复合鞘内注射舒芬太尼的疗效。

方法

在这项随机、双盲、安慰剂对照试验中,60例接受TURP的患者被分为两组:羟考酮组(O组,n = 30)和生理盐水组(N组,n = 30)。O组在手术前10分钟静脉注射0.1 mg/kg羟考酮,N组静脉注射0.1 ml/kg生理盐水。所有患者鞘内注射舒芬太尼5 μg + 0.5%布比卡因(0.8 ml)+ 生理盐水0.7 ml,共0.25%布比卡因(1.6 ml)。评估脊髓阻滞特征、血流动力学值、围手术期镇痛需求、视觉模拟评分(VAS)、Ramsay镇静评分及副作用。该研究于2014年3月至9月在中国吉林吉林大学第一医院进行。

结果

O组感觉阻滞2节段消退时间、感觉阻滞完全恢复时间及首次镇痛需求时间更长。O组术后需要镇痛的患者更少,术后4、8、16及24小时的VAS疼痛评分显著更低。

结论

预先静脉注射羟考酮是一种有效且安全的方法,可减轻低剂量稀释布比卡因蛛网膜下腔麻醉复合鞘内注射舒芬太尼患者的术后疼痛并减少曲马多镇痛。

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