羟考酮与舒芬太尼对腹腔镜保胆取石术后疼痛的镇痛效果比较：一项前瞻性随机对照试验。

Comparison of the analgesic effects of oxycodone vs. sufentanil on postoperative pain after laparoscopic gallbladder-preserving cholecystolithotomy: a prospective randomized controlled trial.

作者信息

Wang Ye, Wu Meng, Zhao Lin, Yan Xiaojian, Zhao Lei

机构信息

Department of Anesthesiology, Peking University Shougang Hospital, Beijing, China.

Department of Anesthesiology, Xuanwu Hospital Affiliated with Capital Medical University, Beijing, China.

出版信息

Front Surg. 2024 Apr 24;11:1382759. doi: 10.3389/fsurg.2024.1382759. eCollection 2024.

DOI:10.3389/fsurg.2024.1382759

PMID:38721023

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11076855/

Abstract

BACKGROUND

We aimed to compare the anesthesia induction effects of oxycodone and sufentanil on postoperative pain in patients undergoing laparoscopic gallbladder-preserving cholecystolithotomy, as well as changes in serum levels of inflammatory factors (TNF-α, IL-6, and IL-10) in the perioperative period.

METHODS

Sixty patients who underwent laparoscopic gallbladder-preserving cholecystolithotomy were evenly divided into oxycodone (O) and sufentanil (S) groups. In groups O and S, oxycodone (0.3 mg/kg) and sufentanil (0.3 ug/kg) were administered, respectively, followed by propofol (2 mg/kg) and rocuronium (0.6 mg/kg). In both groups, the intraoperative electroencephalography double-frequency index was used to guide the use of sedative and analgesic drugs, assessing the follow-up analgesic effect (VAS), degree of sedation (Ramsey), and postoperative complications at seven different time points (0, 0.5, 2, 4, 6, 8, and 24 h postoperatively).

RESULTS

Compared with the S group, patients in the O group exhibited lower VAS scores within 24 h postoperatively ( < 0.001), but there was no statistical difference between wound and shoulder pain scores (> 0.05). Regarding postoperative awakening and extubation duration, O group patients experienced shorter times and better remedial analgesia ( < 0.05). In terms of the degree of sedation, the Ramsay score decreased at 0 h postoperatively compared with the S group ( < 0.001).

CONCLUSION

Compared with sufentanil, oxycodone anesthesia induced better postoperative analgesia and less inflammatory responses in patients undergoing laparoscopic gallbladder-preserving cholecystolithotomy.

CLINICAL TRIAL REGISTRATION

This study has been approved by the Ethics Committee of Peking University Shougang Hospital, with ethical approval (No. IRBK-2020-009), and has completed registration in the Chinese Clinical Trials Register (http://www.chictr.org.cn/) (ChiCTR2000031230).

摘要

背景

我们旨在比较羟考酮和舒芬太尼对行腹腔镜保胆取石术患者术后疼痛的麻醉诱导效果，以及围手术期血清炎症因子（TNF-α、IL-6和IL-10）水平的变化。

方法

60例行腹腔镜保胆取石术的患者被均匀分为羟考酮（O）组和舒芬太尼（S）组。在O组和S组中，分别给予羟考酮（0.3 mg/kg）和舒芬太尼（0.3 μg/kg），随后给予丙泊酚（2 mg/kg）和罗库溴铵（0.6 mg/kg）。两组均采用术中脑电图双频指数指导镇静和镇痛药物的使用，评估七个不同时间点（术后0、0.5、2、4、6、8和24 小时）的随访镇痛效果（VAS）、镇静程度（Ramsey）和术后并发症。