ABSTRACT
Objective To observe the analgesia effect of oxycodone hydrochloride injection successive subtraction method background infusion on postoperative analgesia in patients of lobectomy under thoracoscope.Methods Ninety lobectomy under thoracoscope patients, using the random number table method patients were randomly divided into three groups:sufentanil group (group S), the constant speed oxycodone infusion group (Q1) and the decreasing background infusion oxycodone group (Q2), 30 cases in each group. On the time of 10 minutes before the end of surgery, S group was given sufentanil 0.10 μg/kg, Q1 and Q2 group was given oxycodone 0.10 mg/kg, each patient was given intravenous patient-controlled analgesia (PCIA), the group of S set electronic pump sufentanil 2.00 μg/kg (100 ml), background infusion was 0.03 μg/(kg·h), PCA dose was 0.015 μg/kg; The group of Q1 was oxycodone 1.00 mg/kg (100 ml), background dose of 15.00 μg/(kg·h), PCA dose of 15.0 μg/kg; The group of Q2 also was oxycodone 1.00 mg/kg (100 ml), on the first 12 h after operation, the background infusion was 15.00 μg/(kg·h), every 12 h later, the background infusion decreased by 20%, PCA dose was 15.00 μg/kg, all of the pump locking time was 10 minutes, lock 4 times per hour. Recorded the number of hemodynamic on the end of operation, immediate extubation and extubation after 5 minutes. On the time of postoperative 2 h, 8 h, 12 h, 24 h, 48 h, recorded the scores of NRS?, NRS (M), Ramsay. Recorded the times of PCA compression,times of medicaments remedies,the amount of drug use, adverse reactions such as respiratory depression, nausea, vomiting, itching and satisfaction of patients to postoperative analgesia.Results The MAP and HR of three groups of patients were increased in the time of tube drawing (P 0.05). The score of NRS ? in the groups of Q1 and Q2 was lower than group S at the time of (T3~5) (P < 0.05), the score of NRS (M) in the groups of Q1 and Q2 was lower than group S at the time of (T3~6) also. The Ramsay score of Q1 and Q2 group was higher than the group S in the point (T3~7). Which the times of PCA and remedial drug use, sleep disturbed times in the first day and second day of group Q1 and Q2 was lower than the group S (P < 0.05). The volume of drug use at 48 h in the group of Q2 was lower than the group Q1 and S (P < 0.05). Postoperative nausea and vomiting of group Q2 was lowered than group S (P < 0.05). The satisfaction of Patients to postoperative analgesia in the group Q2 and Q1 was higher than group S (P < 0.05).Conclusion Lobectomy under thoracoscope patients with postoperative application of successive subtraction method background infusion oxycodone can obtain satisfactory analgesia effect with a smooth anesthesia recovery period, satisfied analgesic effect, reduce the dosage of drugs and reduce the adverse reaction.