Zhou Yanjun, Huang Xinyi, Chang Huan, Sun Hongyu, Xie Wenxiu, Pan Ziye, Zhang Fan, Liao Qin
Department of Anesthesiology, The Third Xiangya Hospital, Central South University, Changsha, China.
Department of Anesthesiology, The People's Hospital of Liuyang, Changsha, China.
Front Surg. 2023 Mar 17;10:1111376. doi: 10.3389/fsurg.2023.1111376. eCollection 2023.
To explore the optimal bolus dose of oxycodone for patient controlled intravenous analgesia (PCIA) without background dose in elderly patients after laparoscopic surgery for gastrointestinal cancer.
In this prospective, randomized, double-blind, parallel-controlled study, we recruited patients aged 65 years or older. They underwent laparoscopic resection for gastrointestinal cancer and received PCIA after surgery. Eligible patients were randomly divided into 0.01, 0.02, or 0.03 mg/kg group according to the bolus dose of oxycodone in PCIA. The primary outcome was VAS scores of pain on mobilization at 48 h after surgery. Secondary endpoints included the VAS scores of rest pain, the total and effective numbers of press in PCIA, cumulative dose of oxycodone used in PCIA, the incidence of nausea, vomiting and dizziness, as well as patients' satisfaction at 48 h after surgery.
A total of 166 patients were recruited and randomly assigned to receive a bolus dose of 0.01 mg/kg ( = 55), 0.02 mg/kg ( = 56) or 0.03 mg/kg ( = 55) of oxycodone in PCIA. The VAS scores of pain on mobilization, the total and effective numbers of press in PCIA in 0.02 mg/kg group and 0.03 mg/kg group were lower than those in 0.01 mg/kg group (< 0.05). Cumulative dose of oxycodone used in PCIA and patients' satisfaction in 0.02 and 0.03 mg/kg groups were more than those in 0.01 mg/kg group (< 0.01). The incidence of dizziness in 0.01 and 0.02 mg/kg groups was lower than that in 0.03 mg/kg group (< 0.01). There were no significant differences in VAS scores of rest pain, the incidence of nausea and vomiting among three groups (> 0.05).
For elderly patients undergoing laparoscopic surgery for gastrointestinal cancer, 0.02 mg/kg bolus dose of oxycodone in PCIA without background infusion may be a better choice.
探讨老年胃肠道癌患者腹腔镜手术后自控静脉镇痛（PCIA）中无背景剂量时羟考酮的最佳推注剂量。
在这项前瞻性、随机、双盲、平行对照研究中，我们招募了65岁及以上的患者。他们接受了胃肠道癌的腹腔镜切除术，并在术后接受PCIA。符合条件的患者根据PCIA中羟考酮的推注剂量随机分为0.01、0.02或0.03mg/kg组。主要结局是术后48小时活动时的疼痛视觉模拟评分（VAS）。次要终点包括静息痛的VAS评分、PCIA中的按压总数和有效次数、PCIA中使用的羟考酮累积剂量、恶心、呕吐和头晕的发生率，以及术后48小时患者的满意度。
共招募了166例患者，并随机分配接受PCIA中0.01mg/kg（n = 55）、0.02mg/kg（n = 56）或0.03mg/kg（n = 55）的羟考酮推注剂量。0.02mg/kg组和0.03mg/kg组活动时的疼痛VAS评分、PCIA中的按压总数和有效次数均低于0.01mg/kg组（P < 0.05）。0.02和0.03mg/kg组PCIA中使用的羟考酮累积剂量和患者满意度高于0.01mg/kg组（P < 0.01）。0.01和0.02mg/kg组的头晕发生率低于0.03mg/kg组（P < 0.01）。三组之间静息痛的VAS评分、恶心和呕吐的发生率无显著差异（P > 0.05）。
对于接受腹腔镜胃肠道癌手术的老年患者，PCIA中无背景输注时0.02mg/kg的羟考酮推注剂量可能是更好的选择。
