羟考酮不同给药模式治疗TURP术后膀胱痉挛痛疗效观察

摘要

Objective To compare the efficacy of oxycodone by different administrations in controlling spastic bladder pain after transurethral resection of the prostate (TURP). Methods A total of 90 patients undergoing TURP in Hainan General Hospital from January to August in 2016 were selected. According to random number table, the patients were divided into the patient-controlled intravenous analgesia (PCIA) continuous pump group (OC group), the PCIA sin-gle administration group (OI group) and the control group (C group), with 30 cases in each group. The OC group and OI group were given PCIA pump solution (300 mL oxycodone, 0.1 mg/mL). For the OC group, the PCIA pump was set with 1 mg bolus dose, 5 min lockout interval and background infusion rate of 0.5 mg/h;for the OI group, the PCIA pump was set with 1 mg bolus dose, 5 min lockout interval and no background infusion. In C group, no PCIA were given. All the patient could receive 50 mg tramadol injection when their VAS score>3 after surgery. The frequency and duration of spastic bladder pain, total oxycodone consumption dose, VAS score, patient satisfaction rate and adverse effects at 48 h after TURP were recorded respectively. Results The frequency and duration of spastic bladder pain at 48 h after TURP in the OC and OI group were (4±1) and (41±10) min, (4±1) and (44±17) min, respectively, which were significantly low-er than (8 ± 2) and (144 ± 56) min in the control group (P<0.05). The consumption of oxycodone in 48 h after surgery in the OI group was (21±3) mg, which was significantly lower than (28±4) mg of the OC group (P<0.05). There was no sig-nificant difference in the inciclence of odverse yeactions between the three group (P<0.05). Conclusion The two oxy-codone administration methods both showed effective in relieving spastic bladder pain after TURP. However, intermit-tent injection mode could reduce 48 h oxycodone consumption dose than continuous infusion mode.%目的 探讨羟考酮不同给药模式用于治疗经尿道前列腺电切术(TURP)术后膀胱痉挛痛的效果.方法 选取2016年1～8月在海南省人民医院择期全麻下行TURP术患者90例,术后按数表法随机分为PCIA持续泵注组(OC组)、PCIA单次给药组(OI组)和对照组(C组),每组30例.OC组、OI组患者PCIA泵配方为0.1 mg/mL羟考酮共300 mL.OC组PCIA泵背景剂量为0.5 mg/h,追加量为羟考酮1 mg/次,锁定时间5 min;OI组无背景剂量,追加量为羟考酮1 mg/次,锁定时间5 min;C组无PCIA镇痛,所有患者VAS评分>3分时接受静脉注射曲马多50 mg/次.所有患者VAS评分>3分30 min以上可要求静注曲马多50 mg行补救镇痛.观察术后48 h内患者膀胱痉挛发生次数、总持续时间、羟考酮总量、OC和OI组48 h内补救镇痛药物使用情况及不良反应.结果 OC组和OI组患者48 h膀胱痉挛次数和持续时间分别为[(4±1)次、(41±10)min]和[(4±1)次、(44±17)min],明显低于对照组的(8±2)次、(144±56)min,差异均有统计学意义(P<0.05);OI组和OC组患者48 h羟考酮用量分别为(21±3)mg和(28±4)mg,OI组少于OC组,差异有统计学意义(P<0.05);三组患者不良反应发生率比较差异无统计学意义.结论 羟考酮PCIA持续和单次给药均可为TURP术后膀胱痉挛痛提供满意镇痛,但按需单次给药模式可减少患者术后48 h羟考酮用药总量.