羟考酮对三叉神经微血管减压术患者术后早期恢复质量的影响

发布时间：2018-02-12 23:59

  本文关键词： 羟考酮 舒芬太尼 三叉神经痛 微血管减压术　出处：《临床麻醉学杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的评价羟考酮在三叉神经微血管减压术患者中应用的安全性和有效性,并比较羟考酮与舒芬太尼对三叉神经微血管减压术患者术后早期恢复质量的影响。方法选择择期行三叉神经微血管减压术患者86例,男38例,女48例,年龄18~65岁,BMI 18~30kg/m2,ASAⅠ或Ⅱ级。采用随机数字表法将其分为两组:羟考酮组(O组)和舒芬太尼组(S组),每组43例。两组均接受静-吸复合麻醉,麻醉诱导时O组静脉注射羟考酮0.3mg/kg,S组静脉注射舒芬太尼0.4μg/kg,在手术进行到关硬膜后即刻,O组静脉注射羟考酮0.07mg/kg,S组静脉注射舒芬太尼0.1μg/kg。于术前1d、术后4、24和48h采用数字评分法(numeric rating scale,NRS)评估患者手术切口疼痛和三叉神经区面部疼痛程度。当NRS评分≥4分时O组静脉注射羟考酮3mg,S组静脉注射舒芬太尼5μg进行补救镇痛。于术前1d和术后3d采用40项恢复质量评分量表(QoR-40量表)评估患者恢复质量。记录术后补救镇痛情况、拔管时间、出院时间以及术后恶心呕吐、心动过缓、排尿困难、头晕和瘙痒的发生情况。结果 O组术后3d的QoR-40量表评分中身体舒适度评分、情绪状态评分、心理支持评分、疼痛评分及总评分明显高于S组(P0.05)。O组术后恶心呕吐发生率明显低于S组(20.9%vs 37.2%)(P0.05)。结论在手术时间短于5h的三叉神经微血管减压术患者中,羟考酮0.3mg/kg可安全用于其麻醉诱导,羟考酮0.07mg/kg及3mg可分别安全有效地用于其预防性镇痛及补救镇痛;与舒芬太尼比较,羟考酮可提高三叉神经微血管减压术患者术后早期恢复质量,减少术后恶心呕吐。
[Abstract]:Objective to evaluate the safety and efficacy of hydroxycodone in trigeminal microvascular decompression. To compare the effect of hydroxycodone and sufentanil on the quality of early recovery after microvascular decompression of trigeminal nerve, 86 patients (38 males and 48 females) underwent selective microvascular decompression of trigeminal nerve. The patients were divided into two groups by random digital table method: hydroxone group (O group) and sufentanil group (S group, 43 cases in each group). The two groups received combined intravenous anesthesia and inhaling anesthesia, and the two groups were divided into two groups: hydrocodone group (n = 43) and sufentanil group (n = 43). During anesthesia induction, O group was injected with hydroxycodone 0.3 mg 路kg ~ (-1) 路kg ~ (-1) by intravenous sufentanil 0.4 渭 g 路kg ~ (-1) 路kg ~ (-1). Immediately after operation, O group was given 0.07 mg 路kg ~ (-1) 路kg ~ (-1) of hydroxy codon and 0.1 渭 g / kg 路kg ~ (g / kg) of sufentanil. At 1 day before operation, 424 and 48 hours after operation, the patients in group O were given digital injection of sufentanil (0.1 渭 g / kg). Rating scaleNRS was used to evaluate the degree of surgical incision pain and facial pain in trigeminal nerve area. When NRS score was 鈮，

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