Influence study of oxycodone hydrochloride injection pretreatment on postoperative analgesic and immune function after fracture / 临床外科杂志

ABSTRACT

Objective To observe the effects of oxycodone hydrochloride injection pretreatment on postoperative analgesic and immune function after fracture.Methods 120 patients scheduled to re-ceive orthopedic surgery under general anesthesia were randomly divided into oxycodone hydrochloride in-jection group(groupⅠ)and saline control group(groupⅡ)and 60 cases in each group.GroupⅠreceived pretreatment of 0.1 mg/kg oxycodone hydrochloride injection at 15 min before the end of surgery while groupⅡ received the same volume saline;all accepted postoperative intravenous analgesia postoperative-ly.Monitor visual analogue scores(VAS)at 2,6,12,24,48 h after operation in two groups,postoperative analgesia pressing times in 48 h and the incidence of adverse reactions;record NK cells,CD4 +T lympho-cytes cells,CD8+ T lymphocytes and CD4 +/CD8+ levels at 30min before anesthesia,postoperative 30 min,24 h,48 h.Results Compared with group Ⅱ,VAS scores of group Ⅰ at 2,6 h after operation were lower[(3.3 ± 0.6)vs(4.5 ± 0.7),(2.8 ± 0.5)vs(3.5 ± 0.6)],and 48 h postoperative analgesia press-ing times was less[(6.7 ± 2.2)vs(12.4 ± 2.5)](P<0.05).Compared with groupⅡ,NK cells,CD4 +T cells and CD4 +/CD8 +levels of group Ⅰ at 24 h,48 h after operation were higher[(10.2 ± 1.2)vs (9.1 ± 1.3),(9.6 ± 1.4)vs(8.4 ± 1.3);(40.5 ± 3.1)vs(37.4 ± 2.6),(39.6 ± 3.3)vs(34.3 ± 3.6);(1.6 ± 0.3)vs(1.3 ± 0.2),(1.5 ± 0.3)vs(1.2 ± 0.3)],and CD8+ T lymphocyte cell level was lower[(25.9 ± 2.2)vs(28.9 ± 2.1);(26.7 ± 2.3)vs(29.2 ± 2.5)](P<0.05);and in intra-group comparison,NK cells,CD4 +T cells and CD4 +/CD8 +levels of group Ⅰ,Ⅱ at 24 h,48 h after operation were higher,and CD8 +T lymphocyte cell level was lower(P <0.05). The adverse effects of the two groups had no significant difference(P>0.05).Conclusion Oxycodone hydrochloride injection precon-ditioning on postoperative analgesic after fracture has better effect,it can reduce the degree of postoperative pain and the degree of immune function decreased after the surgery,but it do not increase the adverse re-action,so clinical should be safe and worthy of promotion.