盐酸羟考酮用于非体外循环冠状动脉旁路移植术后患者自控静脉镇痛的临床观察

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Abstract Objective To observe the clinical effects of Oxycodone hydrochloride on postoperative analgesia after off-pump coronary artery bypass grafting (CABG) in order to optimize the prescription of analgesic pump. Methods Clinical data of off-pump CABG patients in Fuwai Hospital Chinese Academy of Medical Science from October 2015 to April 2016 were retrospectively analyzed. According to the prescription of postoperative analgesic pump, the patients were divided into Oxycodone group (group O) and Sufentanil group (group S) with 50 cases in each group. The analgesic pump in group O was composed of Oxycodone (0.8 mg/kg) and tropisetron (5 mg), and the analgesic pump formula in group S was Sufentanil (1.5 μg/kg) and tropisetron (5 mg). Patient controlled intravenous analgesia (PCIA) began at the end of surgery. The arterial systolic blood pressure (SBP), the arterial diastolic blood pressure (DBP) and the heart rate (HR) were collected at 30 min before extubation(T1), the moment of extubation(T2), 3 h after extubation (T3), and 24 h after extubation(T4)． Pain and sedative scores at each time points of T2 to T4, additional postoperative analgesics, length of postoperative mechanical ventilation, length of intensive care unit (ICU) stay and analgesic related complications were collected. Results At the time point of T2, the HR and SBP of group O were higher than those of group S, the differences were statistically significant (P < 0.05). At the time point of T2, the SBP, DBP, and HR of group O and the SBP of group S were increased significantly compared to the time point of T1 with statistical significance (P < 0.05). There was no significant difference between groups in pain and sedative score, additional postoperative analgesics, length of postoperative mechanical ventilation, length of intensive care unit (ICU) stay and analgesic related complications (P > 0.05). Conclusion Oxycodone hydrochloride is safe and effective for postoperative analgesia in patients undergoing off-pump CABG. There is no significant difference in the clinical analgesic effect between the two prescriptions (0.8 mg/kg Oxycodone and 1.5 μg/kg Sufentanil) of analgesia pumps, and the anesthesiologist should choose them according to their own experience and the patients′ condition.

Key words： Oxycodone Off-pump Coronary artery bypass grafting Controlled intravenous analgesia

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	TIAN Lijuan SHI Sheng ZHANG Zhe▲ CHEN Lei▲

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TIAN Lijuan SHI Sheng ZHANG Zhe▲ CHEN Lei▲. Clinical observation of Oxycodone hydrochloride in patient-controlled intravenous analgesia after off-pump coronary artery bypass grafting[J]. 中国医药导报, 2018, 15(25): 108-111.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I25/108

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