Effect of oxycodone patient-controlled intravenous analgesia after cesarean section: a randomized controlled study.
Effect of oxycodone patient-controlled intravenous analgesia after cesarean section: a randomized controlled study.
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DOI：
10.2147/jpr.s142896
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发表时间：
2017
影响因子：
2.7
通讯作者：
Huang SQ
中科院分区：
文献类型：
--
作者：
Nie JJ;Sun S;Huang SQ
羟考酮是一种半合成的μ阿片受体激动剂，对内脏痛有潜在的良好镇痛效果。本研究旨在比较羟考酮与舒芬太尼静脉自控镇痛(PCIA)的疗效。120例择期剖宫产产妇随机分为4组：舒芬太尼100μg组S组、舒芬太尼70μg羟考酮30 mg组、舒芬太尼50μg羟考酮50 mg组和羟考酮100 mg组。每组均加入雷莫司琼0.3 mg。各组药物稀释至100m L，持续输注−-1 1m L·h，推注剂量2m L，锁定间隔15min。PCIA最大剂量为每小时10毫升。术后比较不同组别的疼痛评分、PCIA剂量和副作用。各时间点(术后6、12、24 h)，O组子宫绞痛量表评分均低于OS1组和S组(P<0.008)，OS2组和OS1组均低于S组(P<；0.008)。O组坐位NRS(S)评分低于其他两组(P<；0.008)。OS2组的S焦虑自评量表评分低于OS1组和S组(P<；0.008)。术后12、24 h，O组静息切口疼痛评分(NRS-R)均低于其他两组(P<；0.008)。在各个时间点，OS2组的神经功能障碍评分均低于OS1组和S组(P<；0.008)。O组各时间点的硬膜外自控镇痛次数和阿片类药物用量均低于OS1组和S组(P<；0.008)。羟考酮PCIA可能比舒芬太尼PCIA更有效地缓解剖宫产术后疼痛，但副作用的发生率有待进一步研究。
Oxycodone is a semisynthetic μ-opioid receptor agonist with a potentially good analgesic efficacy in visceral pain. This study aims to compare the efficacy of oxycodone with sufentanil patient-controlled intravenous analgesia (PCIA). One hundred and twenty primiparas undergoing elective cesarean section were randomized into four groups by different drugs of PCIA: group S (sufentanil 100 μg), group OS1 (sufentanil 70 μg, oxycodone 30 mg), group OS2 (sufentanil 50 μg, oxycodone 50 mg), and group O (oxycodone 100 mg). Ramosetron 0.3 mg was added to each group. In all groups, drugs were diluted to 100 mL and managed with a continuous infusion of 1 mL·h−1, a bolus dose of 2 mL, and a lockout interval of 15 min. The maximum dose of PCIA per hour was 10 mL. After surgery, pain scores, PCIA doses, and side effects were compared among groups. At all time points (6, 12, and 24 h after surgery), Numerical Rating Scale (NRS) of uterine cramping pain (NRS-U) scores in group O were lower than those in groups OS1 and S (P<0.008) and NRS-U scores in groups OS2 and OS1 were lower than that in group S (P<0.008). NRS of moving into the sitting position (NRS-S) scores in group O were lower than those in the other groups (P<0.008). NRS-S scores in group OS2 were lower than those in groups OS1 and S (P<0.008). At 12 and 24 h after surgery, NRS of incision pain at rest (NRS-R) scores in group O were lower than those in the other groups (P<0.008). At all time points, NRS-R scores in group OS2 were lower than those in groups OS1 and S (P<0.008). The number of PCIA boluses and amount of opioid consumption in group O were lower than those in groups OS1 and S at all time points (P<0.008). Oxycodone PCIA may be more effective than sufentanil PCIA for pain relief after cesarean section but the incidence of side effects needs further investigation.