三种不同剂量盐酸羟考酮注射液用于无痛人流术后宫缩痛的有效性和安全性

摘要

目的 评价三种不同剂量盐酸羟考酮注射液用于无痛人流术后宫缩痛的有效性和安全性.方法 择期行无痛人流术的早孕患者150例,按数字表法随机分为Q1组(羟考酮0.04 mg/kg)、Q2组(羟考酮0.07 mg/kg)和Q3组(羟考酮0.1 mg/kg),每组50例.另外选择50例不愿签署知情同意书参加试验的患者为对照组(N组).记录4组患者苏醒后即刻、10、30、60 min的宫缩痛评分和患者术后满意度评分;记录术前痛经程度、手术时间、丙泊酚用量、术后苏醒时间、苏醒期躁动及强度;记录4组患者入室后给药前(T0)、睫毛反射消失时(T1)、宫腔操作时(T2)、术毕唤醒时(T3)的心率(HR)、平均动脉压(MAP)、呼吸频率(RR)、脉搏血氧饱和度(SpO2);记录头晕、恶心、呕吐、认知障碍、出汗、皮肤瘙痒、尿潴留、呼吸抑制等不良反应的发生率.结果 4组患者各时点宫缩痛VAS评分比较,Q2组和Q3组显著低于Q1组和N组(P＜0.05);术后满意度评分比较,Q2组和Q3组显著高于Q1组和N组(P＜0.05);丙泊酚用量比较,Q2组和Q3组显著低于Q1组和N组(P＜0.05);术后苏醒时间比较,Q2组和Q3组显著低于N组和Q1组(P＜0.05);4组患者一般资料、术前痛经程度、手术时间、各时点生命体征比较、头晕、恶心呕吐、认知障碍等不良反应发生率差异无统计学意义(P＞0.05).4组患者均未发生苏醒期躁动、皮肤瘙痒、出汗、尿潴留、呼吸抑制等不良反应.结论 0.07 mg/kg盐酸羟考酮注射液用于无痛人流术,麻醉镇痛效果确切,镇痛作用完善,患者满意度高,值得临床推广使用.%Objective To evaluate the effectiveness and safety of three different doses of oxycodone hydrochloride injection in treatment of postoperative uterus contraction pain after painless artificial abortion surgery.Methods A total of 150 early pregnancy patients with painless artificial abortion surgery were randomly divided into Q1 group (oxycodone 0.04 mg/kg),Q2 group (oxycodone 0.07 mg/kg) and Q3 group (oxycodone 0.1 mg/kg),50 cases in each group.Another 50 patients refused to sign the informed consent were selected as group N.The uterine contraction pain score at the time points of immediately after recovery and 10,30,and 60 min after recovery were recorded in four groups,and postoperative satisfaction degree were recorded as well.Preoperative degree of dysmenorrhea,surgery time,propofol dosage,postoperative recovery time,agitation and strength were recorded.At the time points of before administration (To),loss of eyelash reflex (T1),uterine cavity operation (T2),postoperative wake (T3),the heart rate (HR),mean arterial pressure (MAP),respiratory rate (RR) and pulse oxygen saturation (SpO2) were recorded.The incidence of adverse reactions such as dizziness,nausea and vomiting,cognitive impairment,sweating,skin itching,urinary retention,respiratory suppression were recorded.Results The VAS of uterus contraction pain in Group Q2 and Q3 were significantly lower than Group Q1 and Group N (P ＜ 0.05).The satisfaction degree of the patients after surgery in Group Q2 and Q3 were significantly higher than Group Q1 and Group N (P ＜ 0.05).The dose of propofol and recovery time in Group Q2 and Q3 were significantly lower than Group Q1 and group N (P ＜ 0.05).There was no significant difference between the four groups in the age,weight,dysmenorrhea,operation time,nausea and vomiting,vital signs,dizziness and cognitive dysfunction (P ＞ 0.05).There were no adverse reactions such as restlessness,pruritus,sweating,urinary retention,respiratory depression in the 4 groups.Conclusion 0.07 mg/kg oxycodone hydrochloride injection for patients with painless artificial abortion surgery can get perfect analgesic effect and high satisfaction degree,so it is worthy of clinical application.