Dang Sha-Jie, Li Rui-Li, Wang Jun, Zeng Wen-Bin, He Yun, Yue Hui-Yu, Li Si-Yuan, Han Li-Chun
Department of Anesthesia, Shaanxi Provincial Cancer Hospital, Xi'an, Shaanxi, People's Republic of China.
The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
J Pain Res. 2020 May 5;13:937-946. doi: 10.2147/JPR.S236933. eCollection 2020.
This study aims to compare analgesic effect and side effects of oxycodone and sufentanil in transition analgesia and patient-controlled intravenous analgesia (PCIA) after gynecological tumor operation under general anesthesia.
A prospective, randomized, double-blind research was conducted. Patients undergoing elective gynecological tumor surgery were randomized into four groups: Group S (sufentanil transition analgesia and sufentanil PCIA), Group OS (oxycodone transition analgesia and sufentanil PCIA), Group SO (sufentanil transition analgesia and oxycodone PCIA) and Group O (oxycodone transition analgesia and oxycodone PCIA). The primary outcomes were Numerical Rating Scale (NRS) at rest and coughing, accumulated opioid consumption in PCIA and patients' satisfaction.
Patients in Group OS and Group O showed shorter time of consciousness recovery and extubation after surgery. Accumulated opioid consumption in PCIA (equal to morphine) in Group SO and Group O was significantly less than that in Group S and Group OS. Patients in Group O showed lower NRS at rest and coughing, but higher patients' satisfaction 3, 24 and 48 hours after surgery. Patients in Group SO and Group O showed a shorter time of intestinal recovery, first feeding and first-time movement.
Both oxycodone and sufentanil provided adequate pain relief in transitional analgesia and PCIA treatment after surgery. Oxycodone without background infusion showed less analgesic drug consumption and faster recovery than sufentanil with background infusion in PCIA after gynecological tumor operation under general anesthesia.
本研究旨在比较羟考酮和舒芬太尼在全身麻醉下妇科肿瘤手术后过渡镇痛及患者自控静脉镇痛（PCIA）中的镇痛效果和副作用。
进行一项前瞻性、随机、双盲研究。择期行妇科肿瘤手术的患者被随机分为四组：S组（舒芬太尼过渡镇痛和舒芬太尼PCIA）、OS组（羟考酮过渡镇痛和舒芬太尼PCIA）、SO组（舒芬太尼过渡镇痛和羟考酮PCIA）和O组（羟考酮过渡镇痛和羟考酮PCIA）。主要观察指标为静息和咳嗽时的数字评分量表（NRS）、PCIA中阿片类药物的累积用量及患者满意度。
OS组和O组患者术后意识恢复和拔管时间较短。SO组和O组PCIA中阿片类药物的累积用量（相当于吗啡）显著低于S组和OS组。O组患者在术后3、24和48小时静息和咳嗽时的NRS较低，但患者满意度较高。SO组和O组患者肠道恢复、首次进食和首次活动时间较短。
羟考酮和舒芬太尼在术后过渡镇痛和PCIA治疗中均能提供充分的疼痛缓解。在全身麻醉下妇科肿瘤手术后的PCIA中，无背景输注的羟考酮比有背景输注的舒芬太尼镇痛药物用量更少，恢复更快。
