羟考酮与舒芬太尼用于乳腺癌手术全身麻醉的比较

摘要

Objective To explore the efficacy and the safety of oxycodone hydrochloride injection in the induction and maintenance of general anesthesia in breast cancer patients.Methods A total of 200 female patients,aged 25-65 years,ASA physical status Ⅰ or Ⅱ,scheduled for elective breast-conservative surgery,were randomly divided into 2 groups (n=100 each): oxycodone hydrochloride group (group O) and sufentanil group (group S).Oxycodone 0.2 mg/kg (group O) or sufentanil 0.2 μg/kg (group S) with propofol 2 mg/kg and cisatracurium 0.15 mg/kg were administered intravenously for general anesthesia induction.Propofol target-controlled infusion combined with remifentanil were used for maintenance of general anesthesia during the operation.Anesthesia time,awake time,extubation time,total consumption of propofol and remifentanil were recorded.The adverse events and VAS scores after surgery were observed.Results There was no significant difference between groups in anesthesia time,awake time,extubation time,consumption of propofol and remifentanil.Compared with group S,group O had lower VAS score at 2 h after surgery (P<0.05),but with no significant difference at other time points.There was no significant difference at the incidence of moderate pain between group.The incidence of dizziness was 18% in both groups.The incidence of nausea was 11 (11%) in group S and 9 (9%) in group O with no significant difference.Conclusion Taken together,oxycodone hydrochloride used for general anesthesia in breast cancer patient is practicable.%目的 观察和比较羟考酮与舒芬太尼用于乳腺癌患者全麻诱导及维持的安全性和有效性.方法 选择择期行乳腺癌局部扩大切除术的女性患者200例,年龄25~65岁,ASA Ⅰ或Ⅱ级,随机分为两组:羟考酮组(O组)和舒芬太尼组(S组),每组100例.静脉注射羟考酮0.2 mg/kg(O组)或舒芬太尼0.2 μg/kg(S组)、丙泊酚2 mg/kg与顺式阿曲库铵0.15 mg/kg行全麻诱导.术中采用丙泊酚和瑞芬太尼靶控输注维持麻醉.记录麻醉时间、苏醒时间、拔管时间及术中丙泊酚和瑞芬太尼用量;记录拔管后VAS疼痛评分和不良反应的发生情况.结果 两组患者麻醉时间、苏醒时间、拔管时间、术中丙泊酚和瑞芬太尼用量差异无统计学意义.术后2 h O组静态和动态VAS疼痛评分明显低于S组(P<0.05),其他时点及组间比较差异均无统计学意义.两组拔管后各时点静态和动态中度以上疼痛发生率差异无统计学意义.两组患者术后均有18例(18%)发生头晕,O组和S组分别有11例(11%) 和9例(9%)发生恶心,但差异无统计学意义.结论 与舒芬太尼比较,羟考酮也可安全有效地用于乳腺癌局部扩大切除手术的全麻诱导及维持.