Comparison of Analgesia,Sedative Effect and Safety of Oxycodone and Fentanyl after Laparoscopic Hysterectomy / 中国药房

ABSTRACT

OBJECTIVE:To compare the analgesia,sedative effect and safety of oxycodone and fentanyl after laparoscopic hysterectomy. METHODS:A total of 113 patients underwent selective laparoscopic hysterectomy during Aug. 2015-Apr. 2017 were selected and divided into oxycodone group(58 cases)and fentanyl group(55 cases)according to random number table. Oxycodone group received 0.07 mg/kg Oxycodone hydrochloride injection intravenously before skin suture. Fentanyl group received 0.7 μ g/kg Fentanyl citrate injection intravenously before skin suture. The patients were given relevant drugs for patient-controlled intravenous analgesia after they woke up. Hear rate(HR),central venous pressure(CVP),mean arterial pressure(MAP)and oxygen partial pressure [p(O2)] were observed in 2 groups before analgesia induction(T0),at the moment of extubation(T1),5 min after extubation(T2). VAS score and Ramsay sedation score were observed 1 h(T3),6 h(T4),12 h(T5),24 h(T6),48 h(T7)after surgery.The levels of serum P substance and 5-HT were observed before analgesia induction(T0),1 h(T3),6 h(T4),12 h(T5),24 h(T6),48 h(T7)after surgery. The occurrence of ADR were recorded. RESULTS:At T1and T2,HR and MAP of 2 groups were significantly higher than at T0,and oxycodone group was significantly lower than fentanyl group,with statistical significance(P<0.05);there was no statistical significance in the levels of CVP or p(O2)between 2 groups at different time points(P>0.05). At T3-T6,VAS score of oxycodone group was significantly lower than that of fentanyl group,with statistical significance(P<0.05). There was no statistical significance in VAS score at T7or Ramsay score at T3-T7between 2 groups(P>0.05).The levels of serum P substance and 5-HT in 2 groups at T3,T6and T7were significantly higher than at T0;at T3,T6,the oxycodone group were significantly lower than the fentanyl group,with statistical significance(P<0.05).At T7,there was no statistical significance in the levels of serum P substance and 5-HT between 2 groups(P>0.05). Total incidence of ADR in oxycodone group(12.1%)was significantly lower than fentanyl group(27.3%),with statistical significance(P<0.05).CONCLUSIONS:Oxycodone is better than fentanyl in maintaining hemodynamic stability,early reducing the serum levels of pain-induced substances,early analgesic effects for patients underwent laparoscopic hysterectomy,but sedative effect of them are similar.