目的 比较单剂量盐酸羟考酮和地佐辛用于妇科腔镜手术后的镇痛效果.方法 选择美国麻醉医师协会(ASA)Ⅰ或Ⅱ择期行全麻下妇科腹腔镜手术患者60例,随机分为羟考酮组和地佐辛组,各30例.手术结束前15 min,2组分别给予羟考酮0.1 mg/kg、地佐辛5 mg.手术结束前20 min,2组均给予托烷司琼5 mg.均采用靶控输注丙泊酚和瑞芬太尼进行麻醉诱导和维持.记录患者苏醒期躁动评分,麻醉诱导前、拔管前5 min、拔管时和拔管后5 min的平均动脉压(MAP)和心率(HR),以及术后2、4、6、24 h时静息、运动疼痛视觉模拟(VAS)评分.当VAS评分＞40时,静脉注射曲马多1 mg/kg,记录镇痛补救例数,术后恶心、呕吐、头晕、发热、呼吸抑制和瘙痒等不良反应的发生情况.结果 2组苏醒期躁动评分,不同时点MAP、HR差异均无统计学意义.羟考酮组术后2、4 h时静息VAS评分、术后2 h时运动VAS评分均低于地佐辛组(P＜0.05),其余时点与地佐辛组差异无统计学意义.羟考酮组除恶心的发生率高于地佐辛组外,2组其他不良反应的发生率和镇痛补救差异无统计学意义.结论 单剂量盐酸羟考酮0.1 mg/kg可用于妇科腔镜手术后镇痛,其术后镇痛效果优于地佐辛,但要注意不良反应恶心的发生.%Objective To compare the postoperative analgesic effect of the single dose of oxycodone and dezocine in patients who underwent gynecological laparoscopic operation. Methods Sixty patients who underwent elective gynecological laparoscopic operation were randomly divided into two groups (n=30): oxycodone group (group O) and dezocine group (group D). Fifteen minutes before the end of surgery, oxycodone 0.1 mg/kg was given in O group, and dezocine 5 mg was given to D group. Twenty minutes before the end of surgery, tropisetron 5 mg was given to both groups. Analgesia was maintained by propofol-remifentanil with TCI. The mean arterial pressure (MAP) and heart rate (HR) of T1, T2, T3 and T4 were recorded respectively in both two groups. After the operation, pain of visual analogue scale (VAS) was assessed in 2 h ,4 h , 6 h and 24 h, respectively. Results There were no significant differences in MAP and HR between two groups at T1, T2, T3 and T4 (P＞0.05). The VAS score was significantly lower in group O than that of group D (P＜0.05). There was significant difference in the incidence of nausea between the two groups (P＜0.05). Conclusion Single dose of oxycodone 0.1 mg/kg can be used for postoperative analgesia after gynecological laparoscopic operation, and which has better analgesia than that of dezocine, except for the adverse reaction of nausea.
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