Nie Jing-Jing, Sun Shen, Huang Shao-Qiang
Department of Anesthesiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
J Pain Res. 2017 Nov 10;10:2649-2655. doi: 10.2147/JPR.S142896. eCollection 2017.
Oxycodone is a semisynthetic μ-opioid receptor agonist with a potentially good analgesic efficacy in visceral pain. This study aims to compare the efficacy of oxycodone with sufentanil patient-controlled intravenous analgesia (PCIA).
One hundred and twenty primiparas undergoing elective cesarean section were randomized into four groups by different drugs of PCIA: group S (sufentanil 100 μg), group OS1 (sufentanil 70 μg, oxycodone 30 mg), group OS2 (sufentanil 50 μg, oxycodone 50 mg), and group O (oxycodone 100 mg). Ramosetron 0.3 mg was added to each group. In all groups, drugs were diluted to 100 mL and managed with a continuous infusion of 1 mL·h, a bolus dose of 2 mL, and a lockout interval of 15 min. The maximum dose of PCIA per hour was 10 mL. After surgery, pain scores, PCIA doses, and side effects were compared among groups.
At all time points (6, 12, and 24 h after surgery), Numerical Rating Scale (NRS) of uterine cramping pain (NRS-U) scores in group O were lower than those in groups OS1 and S (<0.008) and NRS-U scores in groups OS2 and OS1 were lower than that in group S (<0.008). NRS of moving into the sitting position (NRS-S) scores in group O were lower than those in the other groups (<0.008). NRS-S scores in group OS2 were lower than those in groups OS1 and S (<0.008). At 12 and 24 h after surgery, NRS of incision pain at rest (NRS-R) scores in group O were lower than those in the other groups (<0.008). At all time points, NRS-R scores in group OS2 were lower than those in groups OS1 and S (<0.008). The number of PCIA boluses and amount of opioid consumption in group O were lower than those in groups OS1 and S at all time points (<0.008).
Oxycodone PCIA may be more effective than sufentanil PCIA for pain relief after cesarean section but the incidence of side effects needs further investigation.
羟考酮是一种半合成的μ-阿片受体激动剂，在内脏疼痛方面可能具有良好的镇痛效果。本研究旨在比较羟考酮与舒芬太尼患者自控静脉镇痛（PCIA）的疗效。
120例择期剖宫产的初产妇按PCIA使用不同药物随机分为四组：S组（舒芬太尼100μg）、OS1组（舒芬太尼70μg，羟考酮30mg）、OS2组（舒芬太尼50μg，羟考酮50mg）和O组（羟考酮100mg）。每组均加入0.3mg雷莫司琼。所有组药物均稀释至100mL，持续输注速度为1mL·h，单次给药剂量为2mL，锁定时间间隔为15分钟。PCIA每小时最大剂量为10mL。术后比较各组疼痛评分、PCIA用量及副作用。
在所有时间点（术后6、12和24小时），O组子宫收缩痛数字评分量表（NRS-U）评分低于OS1组和S组（<0.008），OS2组和OS1组的NRS-U评分低于S组（<0.008）。O组坐起时NRS（NRS-S）评分低于其他组（<0.008）。OS2组的NRS-S评分低于OS1组和S组（<0.008）。术后12和24小时，O组静息时切口痛NRS（NRS-R）评分低于其他组（<0.008）。在所有时间点，OS2组的NRS-R评分低于OS1组和S组（<0.008）。在所有时间点，O组PCIA单次给药次数和阿片类药物用量均低于OS1组和S组（<0.008）。
剖宫产术后羟考酮PCIA在缓解疼痛方面可能比舒芬太尼PCIA更有效，但副作用发生率需进一步研究。
