Department of Anesthesiology, Shengjing Hospital, China Medical University, Shanghai, China.
J Clin Pharmacol. 2019 Aug;59(8):1144-1150. doi: 10.1002/jcph.1408. Epub 2019 Mar 15.
More than 30% of patients who undergo surgery will experience postoperative nausea and vomiting (PONV) if no prophylactic treatments are used. Although numerous studies have been performed to investigate the factors related to PONV, the effect of perioperative intravenous oxycodone on the incidence of PONV has not been well investigated. In this study, gynecological patients (grade I-II, aged 18-65 years, scheduled to undergo elective gynecological laparoscopic surgery under general anesthesia) were randomized to the oxycodone group or the sufentanil group. In the oxycodone group, patients received intravenous oxycodone for the induction and maintenance of anesthesia, as well as postoperative analgesia, while sufentanil was used in the sufentanil group. The primary outcome variable was the incidence of PONV. As secondary outcomes, time to first PONV, the rating of the most severe PONV, postoperative pain scores at different time points, hemodynamics, and side effects were evaluated. We found that, compared with sufentanil, oxycodone decreased the incidence of PONV by 13.5% (P = .041). The time to first vomiting was longer in the oxycodone group than in the sufentanil group. Postoperative pain scores at different time points and hemodynamics were comparable between the oxycodone and sufentanil groups. We concluded that the incidence of PONV in gynecological patients who underwent laparoscopic surgery was lower when using intravenous oxycodone for anesthesia induction, anesthesia maintenance, and postoperative analgesia than when using intravenous sufentanil. However, oxycodone and sufentanil provided the same stable hemodynamics during surgery and satisfactory postoperative analgesia.
超过 30%接受手术的患者如果不使用预防措施,将会经历术后恶心和呕吐(PONV)。尽管已经进行了许多研究来调查与 PONV 相关的因素,但围手术期静脉内羟考酮对 PONV 发生率的影响尚未得到很好的研究。在这项研究中,妇科患者(I-II 级,年龄 18-65 岁,计划在全身麻醉下接受择期妇科腹腔镜手术)被随机分配到羟考酮组或舒芬太尼组。在羟考酮组中,患者接受静脉内羟考酮进行麻醉诱导和维持,以及术后镇痛,而舒芬太尼则用于舒芬太尼组。主要观察变量是 PONV 的发生率。次要观察变量包括首次 PONV 的时间、最严重 PONV 的评分、不同时间点的术后疼痛评分、血液动力学和副作用。我们发现,与舒芬太尼相比,羟考酮降低了 13.5%的 PONV 发生率(P =.041)。羟考酮组首次呕吐的时间长于舒芬太尼组。不同时间点的术后疼痛评分和血液动力学在羟考酮组和舒芬太尼组之间无差异。我们得出结论,与静脉内舒芬太尼相比,妇科腹腔镜手术患者在麻醉诱导、麻醉维持和术后镇痛时使用静脉内羟考酮,PONV 的发生率较低。然而,羟考酮和舒芬太尼在手术期间提供了相同的稳定血液动力学和令人满意的术后镇痛。