Department of Anaesthesiology, Cancer Hospital of the University of Chinese Academy and Sciences. Zhejiang, Hangzhou, 310022, China.
Int J Med Sci. 2020 Aug 12;17(14):2194-2199. doi: 10.7150/ijms.47067. eCollection 2020.
: Sedation and analgesia use in percutaneous radiofrequency ablation (RFPA) for liver cancer is a necessary part of the procedure; however, the optimal medicine for sedation and analgesia for PRFA remains controversial. The aim of this study was to compare the perioperative pain management, haemodynamic stability and side effects between oxycodone (OXY) and fentanyl (FEN) use in patients under dexmedetomidine sedation. Two hundred and five adults with an American Society of Anaesthesiologists physical status score of I to II were included in this study. Patients were assigned to the OXY (n=101) or FEN (n=104) group. Radiofrequency ablation was performed under spontaneous breathing and with painless anaesthesia administered intravenously. The outcomes included fluctuations in mean arterial pressure, heart rate, side effects and the perioperative numerical rating scale (NRS). Radiofrequency ablation was successfully performed in 205 patients. No significant differences were observed in mean blood pressure fluctuations between the two groups despite the longer durations of ablation and total sedation time in the OXY group. The highest NRS score during the surgery and 1 hour and 2 hours after the surgery were significantly lower in the OXY group than in the FEN group. Heart rate fluctuations were significantly lower in the OXY group than in FEN group throughout the surgery. More patients in the FEN group displayed unwanted body movement and respiratory depression. Both oxycodone and fentanyl can be applied for liver cancer percutaneous radiofrequency ablation; however, oxycodone provides a better patient experience, lower postoperative pain, less respiratory depression and stable haemodynamic fluctuations.
: 在肝癌经皮射频消融 (RFPA) 中使用镇静和镇痛是该手术过程的必要组成部分;然而,PRFA 镇静和镇痛的最佳药物仍存在争议。本研究旨在比较在右美托咪定镇静下使用羟考酮 (OXY) 和芬太尼 (FEN) 进行围手术期疼痛管理、血液动力学稳定性和副作用。本研究纳入了 205 名美国麻醉医师协会身体状况评分 I 至 II 级的成年人。患者被分配到 OXY (n=101) 或 FEN (n=104) 组。射频消融在患者自主呼吸下进行,并通过静脉内无痛麻醉进行。结果包括平均动脉压、心率的波动、副作用和围手术期数字评分量表 (NRS)。205 例患者成功进行了射频消融。尽管 OXY 组消融和总镇静时间较长,但两组间平均血压波动无显著差异。OXY 组在手术期间和手术后 1 小时和 2 小时的最高 NRS 评分明显低于 FEN 组。OXY 组在整个手术过程中心率波动明显低于 FEN 组。FEN 组更多患者出现不自主的身体运动和呼吸抑制。羟考酮和芬太尼均可用于肝癌经皮射频消融;然而,羟考酮可提供更好的患者体验、更低的术后疼痛、更少的呼吸抑制和更稳定的血液动力学波动。