盐酸羟考酮与舒芬太尼对人工全髋关节置换手术患者术后早期恢复质量的影响

摘要

目的 观察盐酸羟考酮和舒芬太尼对人工全髋关节置换术后患者早期恢复质量的影响.方法 前瞻性选取2016年1月至2017年2月择期行全髋关节置换手术患者136例为研究对象,随机分为观察组、对照组、复合组,3组麻醉诱导剂维持方法相同,镇痛泵所用药不同,观察组选取盐酸羟考酮,对照组为舒芬太尼,复合组取盐酸羟考酮+舒芬太尼.比较3组术后即刻(T1)、术后6h(T2)、12h(T3)、24h(T4)、48h(T5) VAS评分、Ramsay镇静评分以及自控镇痛按压次数,记录各组不良反应情况.结果 T2～T4时复合组VAS评分低于观察组和对照组(＜0.05),观察组与对照组各时间段VAS评分差异均无显著性(P＜0.05);T2～T4时对照组Ramsay镇静评分高于观察组和复合组(P＜0.05);复合组48h内自控镇痛按压少于观察组和对照组(＜0.05),观察组与对照组差异无显著性(P＞0.05).复合组未发生呼吸抑制,观察组与对照组呼吸抑制发生率差异无显著性(P＞0.05).观察组和对照组恶心、呕吐、嗜睡、头晕、皮肤瘙痒、口干发生率均高于复合组(P＜0.05).结论 盐酸羟考酮、舒芬太尼均具有较强镇痛作用,但盐酸羟考酮复合舒芬太尼能给人工全髋关节置换术患者提供更为有效且安全的镇痛效果.%Objective To observe the influence of oxycodone hydrochloride and sufentanil on early postoperative recovery quality of patients with artificial total hip replacement surgery. Methods From January 2016 to February 2016, 136 patients with total hip replacement surgery were randomly divided into observation group and control group, composite group. The anesthesia inducers to maintain were the same way, but analgesia pump treatment was different, observation group were given oxycodone hydrochloride,the control group sufentanil, composite group oxycodone hydrochloride + sufentanil. VAS score, Ramsay sedation scores, and self- control analgesia press number at immediate postoperative 6(T1 ), h (T2 ),12 h (T3), 24 h(T4),48 h (T5) were compared, and adverse reactions were recorded. Resulte T2 to T4 composite VAS score was lower than that of the observation group and control group (P ＜ 0.05). The VAS score of observation group and control group in each time period had no significant difference (P ＜0.05). T2 to T4 Ramsay sedation scores of control group was higher than those of observe group and composite group (P ＜0.05). Self- control analgesia pressure of composite group within 48 h was less than those of the observation group and the compound group (P ＜ 0.05). The observation group and control group had no significant difference (P ＞ 0.05). There was no respiratory depression in composite group, respiratory depression happen times of the observation group and control group had no significant difference (P ＞0.05). The nausea, vomiting,lethargy,dizziness, itchy skin,dry mouth incidence of observation group and control group were higher than those of composite group. Conclusion Oxycodone hydrochloride and sufentanil has strong analgesic effect,but oxycodone hydrochloride combined with sufentanil can provide more effective and safe analgesic result.