Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Anesthesiology, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), The First Department of Thoracic Surgery, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China.
Drug Des Devel Ther. 2021 Aug 13;15:3535-3542. doi: 10.2147/DDDT.S316583. eCollection 2021.
To compare the efficacy of a lower dose background infusion of oxycodone for patient-controlled intravenous analgesia (PCIA) with the conventional dose, following intercostal nerve block, for the management of postoperative pain in patients undergoing thoracoscopic lobectomy for lung cancer.
This was a prospective, single-center, randomized, parallel-group, double-blind, controlled clinical trial. In total, 155 patients scheduled for elective radical lobectomy via video-assisted thoracoscopy were recruited from December 2018 to July 2019, of whom 140 were ultimately included in the study population. Patients were randomized to receive either oxycodone 0.25 mg/h (low-dose group, n=70) or oxycodone 0.5 mg/h (control group, n=70) as a background infusion for PCIA, following ropivacaine intercostal nerve block, for postoperative pain management. The primary endpoints were rest and dynamic visual analogue scale (VAS) scores within 72 h of the operation. The secondary endpoints were patient satisfaction scores, consumption of postoperative analgesics, times of patient-controlled analgesia (PCA), and adverse events.
All 140 enrolled patients completed the study requirements and were included in the final analysis. The rest and dynamic VAS scores at 4 h, 24 h, 48 h, and 72 h postoperative were comparable between the low-dose group and the control group (>0.05). However, the low-dose group had statistically significantly higher patient satisfaction scores (<0.001) and lower postoperative analgesic consumption (<0.001) as well as lower incidence of nausea and vomiting (<0.05). The times of PCA was not statistically significantly different between the two groups, and no serious adverse events occurred in either group (>0.05).
A low-dose background infusion of oxycodone for postoperative PCIA can achieve a comparable analgesic effect to the conventional dose after thoracoscopic lobectomy for lung cancer. Furthermore, the low-dose regimen was associated with reduced consumption of oxycodone and increased patient satisfaction.
比较低剂量背景输注羟考酮与常规剂量用于胸腔镜肺叶切除术后患者自控静脉镇痛（PCIA）在管理肺癌患者术后疼痛方面的疗效。
这是一项前瞻性、单中心、随机、平行组、双盲、对照临床试验。共招募了 155 例拟行胸腔镜辅助肺癌根治术的患者，他们于 2018 年 12 月至 2019 年 7 月接受了研究，其中 140 例最终纳入研究人群。患者被随机分配接受背景输注 0.25mg/h 羟考酮（低剂量组，n=70）或 0.5mg/h 羟考酮（对照组，n=70）用于 PCIA，以辅助罗哌卡因肋间神经阻滞用于术后疼痛管理。主要终点是术后 72 小时内的静息和动态视觉模拟评分（VAS）。次要终点是患者满意度评分、术后镇痛药消耗、患者自控镇痛（PCA）次数和不良事件。
所有纳入的 140 例患者均完成了研究要求并纳入最终分析。低剂量组和对照组在术后 4 小时、24 小时、48 小时和 72 小时的静息和动态 VAS 评分无显著差异（>0.05）。然而，低剂量组患者满意度评分显著更高（<0.001），术后镇痛药消耗显著更低（<0.001），恶心和呕吐发生率显著更低（<0.05）。两组 PCA 次数无显著差异，且两组均未发生严重不良事件（>0.05）。
肺癌胸腔镜肺叶切除术后 PCIA 采用低剂量背景输注羟考酮可获得与常规剂量相当的镇痛效果。此外，低剂量方案与减少羟考酮消耗和提高患者满意度相关。
