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目的:观察盐酸羟考酮用于喉癌患者气管切开术的镇痛效果。方法:选择择期行喉癌手术60例,随机分为观察组和对照组各30例。局部麻醉前5min,两组分别静脉注射0.1mg/kg盐酸羟考酮注射液和0.9%氯化钠注射液,均在局部麻醉下完成气管切开术。比较两组平均动脉压(MAP)、心率(HR)、呼吸(RR)和血氧饱和度(SpO_2)等波动情况,以及两组麻醉镇痛评分、应激反应发生情况。结果:对照组MAP注射局麻药(T_1)、气管切开操作时(T_2)较入室时(T_0)显著增高,气管切开手术完毕(T_3)显著降低(P<0.05);HR T_1、T_2、T_3时间节点均较T0显著增高(P<0.05);SpO_2、RR各时间节点差异不显著(P>0.05)。观察组T_1、T_2、T_3各时间节点MAP、HR、SpO2、RR较T0节点均差异不显著(P>0.05)。观察组气管切开时及术后2h、4h、8h镇痛评分分值均显著低于对照组(P<0.05),术后12h两组麻醉镇痛评分分值差异不显著(P>0.05)。观察组应激反应发生率16.7%,显著低于对照组的43.3%(P<0.05)。结论:盐酸羟考酮对喉癌患者气管切开术镇痛效果良好,血流动力学稳定。
Objective: To observe the analgesic effect of oxycodone hydrochloride for tracheotomy in patients with laryngeal cancer. Methods: Sixty patients undergoing laryngeal cancer surgery were randomly divided into observation group and control group with 30 cases each. 5 min before local anesthesia, two groups were intravenous injection of 0.1 mg / kg oxycodone hydrochloride injection and 0.9% sodium chloride injection, tracheostomy were done under local anesthesia. The changes of mean arterial pressure (MAP), heart rate (HR), respiration (RR) and oxygen saturation (SpO_2) were compared between the two groups. The anesthesia analgesia and stress response were compared between the two groups. Results: The levels of T_1, T_2, T_2 and T_2 in tracheotomy group were significantly higher than those in control group (P <0.05) T_3 time points were significantly higher than T0 (P <0.05); SpO_2, RR differences in each node was not significant (P> 0.05). The MAP, HR, SpO2 and RR of the observation group at each time point of T 1, T 2 and T 3 were not significantly different from those of T 0 node (P> 0.05). The scores of analgesia in tracheotomy group and 2h, 4h, 8h after operation in observation group were significantly lower than those in control group (P <0.05), and there was no significant difference between the two groups (P> 0.05) . The incidence of stress reaction in the observation group was 16.7%, significantly lower than that in the control group (43.3%, P <0.05). Conclusion: Oxycodone hydrochloride has good analgesic effect on tracheotomy in patients with laryngeal carcinoma and hemodynamic stability.