Effects of postoperative analgesia with oxycodone on postoperative cognitive dysfunction in aged patients undergoing laparascopic cholecystectomy / 临床麻醉学杂志

ABSTRACT

Objective To investigate effects of postoperative analgesia with oxycodone on post-operative cognitive dysfunction in aged patients undergoing laparascopic cholecystectomy. Methods One hundred and twenty patients scheduled for laparascopic cholecystectomy with general anesthesia,57 males and 63 females,aged 70-80 years,ASA physical status Ⅰ or Ⅱ,were enrolled in the present study.The patients were divided randomly into fentanyl group,sufentanil group and oxycodone group (n=40)according to postoperative analgesia.Visual analog scale (VAS)scores, nausea or vomiting,itching and analgesics consumption of all patients were recorded in the postopera-tive 48 h.Neuropsychological testing was performed with mini-mental state examination (MMSE)on the 7th postoperative day.Results There was no statistical significance between the three groups in VAS scores at different time points in the postoperative 48 h.The incidence of itching,nausea or vomiting in oxycodone group was lower than that in fentanyl group and sufentanil group (P<0.05). Analgesics consumption in fentanyl group and sufentanil group exhibited a negative correlation with MMSE scores on the 7th postoperative day (P<0.01).There was no correlation between analgesics consumption and MMSE scores in oxycodone group.The incidence of POCD was 15 (37.5%)in fent-anyl group,13 (32.5%)in sufentanil group and 7 (17.5%)in oxycodone group.The incidence of POCD in oxycodone group was lower than those in fentanyl group and sufentanil group (P<0.05). Conclusion Oxycodone,replacing fentanyl or sufentanil,can be used for postoperative analgesia and reduce the incidence of POCD with less nausea,vomiting and itching in aged patients.