Wang Wei Jia, Ren Li Ying, Gong Ya Hong, Huang Yu Guang
Department of Anesthesiology, CAMS and PUMC,Beijing 100730,China.
Operating Room,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2020 Feb 28;42(1):91-95. doi: 10.3881/j.issn.1000-503X.11141.
To evaluate the value of oxycodone hydrochloride for postoperative pain management in patients undergoing patient-controlled intravenous analgesia(PCIA). The medical records on postoperative pain management in our department from January 1 to June 30,2018,were retrospectively analyzed.Totally 136 patients were assigned into oxycodone,sufentanil,or morphine groups according to the opioid used in the PCIA.Patients were assessed for postoperative pain severity(scored with NRS)and adverse reactions 24,36,and 48 hours after surgery.The area under curve(AUC)was calculated. The score of pain at exercise was significantly lower in the oxycodone group(2.2±2.4)than in the sufentanil group(3.4±2.1)(=0.305,=0.0126)or the morphine group(3.4±1.7)(=0.104,=0.0277)36 hours after surgery.AUC at rest was significantly lower in the oxycodone and morphine groups than in the sufentanil group(29.00,27.00,and 40.01,respectively);in contrast,AUC at exercise was significantly lower in the oxycodone group(63.17)than in the sufentanil and morphine groups(82.00 and 80.93,respectively).The consumption of opioids was significantly higher in the sufentanil group[(37.2±16.1),(46.1±24.3),(64.4±33.4)mg]than in the oxycodone group[(20.4±14.8)(=3.571,=0.001),(24.2±16.1)(=4.63,<0.0001),(34.4±25.1)mg(=6.409,<0.0001)]or the morphine group[(16.6±11.7)(=4.233,<0.0001),(20.5±14.1)(=5.250,<0.0001),(28.8±19.0)mg(=7.354,<0.0001)]24,36,48 hours after surgery.The oxycodone group experienced less vomiting(=11.360,=0.003)and early termination of PCIA(=7.914,=0.019)compared with the other two groups. Oxycodone can be used for postoperative PCIA.It can alleviate a variety of postoperative pain,with superior analgesic efficiency and safety to sufentanil and morphine.
评估盐酸羟考酮用于患者自控静脉镇痛（PCIA）术后疼痛管理的价值。回顾性分析我科2018年1月1日至6月30日术后疼痛管理的病历。根据PCIA中使用的阿片类药物，将136例患者分为羟考酮组、舒芬太尼组或吗啡组。在术后24、36和48小时评估患者的术后疼痛严重程度（用NRS评分）和不良反应。计算曲线下面积（AUC）。术后36小时，羟考酮组运动时疼痛评分（2.2±2.4）显著低于舒芬太尼组（3.4±2.1）（t=0.305，P=0.0126）或吗啡组（3.4±1.7）（t=0.104，P=0.0277）。静息时AUC在羟考酮组和吗啡组显著低于舒芬太尼组（分别为29.00、27.00和40.01）；相反，运动时AUC在羟考酮组（63.17）显著低于舒芬太尼组和吗啡组（分别为82.00和80.93）。术后24、36、48小时，舒芬太尼组阿片类药物消耗量[（37.2±16.1）、（46.1±24.3）、（64.4±33.4）mg]显著高于羟考酮组[（20.4±14.8）mg（t=3.571，P=0.001）、（24.2±16.1）mg（t=4.63，P<0.0001）、（34.4±25.1）mg（t=6.409，P<0.0001）]或吗啡组[（16.6±11.7）mg（t=4.233，P<0.0001）、（20.5±14.1）mg（t=5.250，P<0.0001）、（28.8±19.0）mg（t=7.354，P<0.0001）]。与其他两组相比，羟考酮组呕吐发生率较低（χ²=11.360，P=0.003）且PCIA提前终止率较低（χ²=7.914，P=0.019）。羟考酮可用于术后PCIA。它能缓解多种术后疼痛，镇痛效果和安全性优于舒芬太尼和吗啡。
