医学临床研究
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医学临床研究  2018, Vol. 35 Issue (10): 1911-1913    DOI: 10.3969/j.issn.1671-7171.2018.10.013
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羟考酮注射液用于乳腺区段切除术患者围术期的镇痛效果及对血浆致痛因子的影响
王承志, 甘建辉, 何双亮, 涂青, 于虹, 吴雨思
华北理工大学附属人民医院麻醉科,河北 唐山 063000
Effect of Oxycodone Hydrochloride Injection as Preemptive Analgesia on Analgesic Action and Pain-producing Factors in Segmental Mastectomy
WANG Chen-zhi, GAN Jian-hui, HE Shuang-liang, et al
The Affiliated Tangshan people Hospital of North China University of Science and Technology, Tangshan, 063000, China
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摘要 【目的】探讨盐酸羟考酮注射液超前镇痛对乳腺肿瘤患者行区段切除术中的镇痛效果及血浆致痛因子的影响。【方法】本院局麻下接受乳腺区段切除术的患者60例随机分为两组。A组患者于局麻前将盐酸羟考酮注射液10 mg,用生理盐水稀释至10 mL静注。B组则局麻前静注生理盐水10 mL。记录手术切皮即刻(T1)、切皮后10 min(T2)、手术结束时(T3)及术后3 h(T4)患者的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)水平,并对患者进行VAS疼痛评分,分别在T1~T4时检测血浆致痛物质5-羟色胺(5-HT)和P物质水平。记录术中局麻药使用总量及不良反应。【结果】与B组比较,A组患者MAP在T1、T2时更低,HR则在T1、T2、T3时更低(P<0.05);A组T1~T4时患者VAS疼痛评分均明显更低(P<0.05);与T1比较,B组患者在T2~T4时血浆中P物质及5-HT水平均存在不同程度升高(P<0.05),且高于A组(P<0.05),而A组患者术中各时间点比较无明显差异(P>0.05)。A组患者术中局麻药总用量要明少于B组(P<0.05);两组术中恶心呕吐等不良反应发生率比较无明显差异(P>0.05)。【结论】盐酸羟考酮注射液超前镇痛能够有效的缓解行乳腺肿瘤患者行区段切除术术中及术后疼痛评分,减少血浆中致痛物质水平,显著减少术中局麻药使用量。
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关键词 乳腺肿瘤/外科学羟可酮/药理学镇痛    
Abstract:【Objective】To explore the effect of oxycodone hydrochloride injection as preemptive analgesia on the analgesic effect and plasma pain-producing factors in segmental resection of breast cancer mastectomy. 【Methods】 A total of 60 patients who underwent segmental mastectomy in our hospital under local anesthesia were randomly divided into two groups: group A and group B. Patients in group A received intravenous oxycodone hydrochloride injection 10mg dissolved in 10ml of normal saline before local anesthesia, while patients in group B were injected with 10ml of normal saline. The vital signs of MAP, HR, SpO2 and VAS scores at the time of surgical incision (T1), 10 min after incision (T2), at the termination of operation (T3), and 3h after the operation (T4) were recorded. Peripheral venous blood(3ml) was drawn to detect 5-HT and substance P at T1~T4. The total dose of local anesthetic and adverse reactions during surgery were compared as well.【Results】 Compared to group B, MAP in group A was lower at T1 and T2, while HR was lower at T1, T2 and T3 (P<0.05). Patients in group A had significantly lower VAS scores at T1~ T4 than those in group B(P<0.05). Compared to T1, the plasma levels of substance P and 5-HT in group B were elevated to some degree at T2~ T4, which were also higher than those in group A (P<0.05). While there were no significant differences of substance P and 5-HT plasma levels in group A at T1~T4(P>0.05). Compared to group B, substance P and 5-HT levels in group A were lower than those in group B at T2~T4 (P<0.05). Meanwhile, the total dose of local anesthetic in patients of group A was significantly lower than that in group B( P<0.05). However, there was no statistically significant difference in the incidence of adverse reactions such as nausea and vomiting between the two groups (P>0.05). 【Conclusion】Application of preemptive analgesia with oxycodone hydrochloride injection in breast cancer patients having segmental mastectomy can significantly alleviate intraoperative and postoperative pain intensity, decrease levels of plasma 5-HT and substance P, and reduce the amount of local anesthetic used.
Key wordsBreast Neoplasms/SU    Oxycodone/PH    Analgesia
收稿日期: 2018-06-29     
PACS:  R737.9  
通讯作者: E-mail: gjh71@163.com   
引用本文:   
王承志, 甘建辉, 何双亮, 涂青, 于虹, 吴雨思. 羟考酮注射液用于乳腺区段切除术患者围术期的镇痛效果及对血浆致痛因子的影响[J]. 医学临床研究, 2018, 35(10): 1911-1913.
WANG Chen-zhi, GAN Jian-hui, HE Shuang-liang, et al. Effect of Oxycodone Hydrochloride Injection as Preemptive Analgesia on Analgesic Action and Pain-producing Factors in Segmental Mastectomy. JOURNAL OF CLINICAL RESEARCH, 2018, 35(10): 1911-1913.
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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2018.10.013     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2018/V35/I10/1911
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