Efficacy of PCIA with oxycodone mixed with dexmedetomidine for analgesia after combined pancreas-kidney transplantation / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the efficacy of patient-controlled intravenous anesthesia (PCIA) with oxycodone mixed with dexmedetomidine for analgesia after combined pancreas-kidney transplantation.Methods Forty American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients,aged 18-64 yr,weighing 40-100 kg,scheduled for elective combined allogeneic pancreas-kidney transplantation,were randomly divided into 2 groups (n =20 each)sufentanil group (group S) and oxycodone combined with dexmedetomidine group (group OD).PCIA was performed at the end of surgery.PCIA solution contained sufentanil 2.0 μg/kg and tropisetron 5 mg in 100 ml of normal saline in group S,and oxycodone 0.6 mg/kg,dexmedetomidine 0.48 μg/kg and tropisetron 5 mg in 100 ml of normal saline in group OD.The PCIA pump was set up with a 0.5 ml bolus dose,a 15 min lockout interval and background infusion at a rate of 2 ml/h.Ramsay sedation score and visual analog scale score were recorded at 4,12,24 and 48 h after surgery.The development and degree of agitation were recorded within 48 h after surgery.The development of adverse reactions such as nausea and vomiting,pruritus and respiratory depression was recorded.Venous blood samples were collected at 12 and 24 h after surgery for determination of serum blood urea nitrogen,creatinine and cystatin C concentrations,and the urine volume was calculated.Results Compared with group S,visual analog scale score was significantly decreased,Ramsay sedation score was increased,the rate of satisfactory sedation was increased,the incidence of agitation,nausea and vomiting was decreased,the serum blood urea nitrogen,creatinine and cystatin C concentrations were decreased,and the urine volume was increased at each time point after surgery (P＜0.05),and no significant change was found in the degree of agitation or incidence of pruritus in group OD (P＞0.05).Conclusion PCIA with oxycodone mixed with dexmedetomidine provides reliable efficacy and higher safety when used for analgesia after combined pancreas-kidney transplantation and is helpful in promoting recovery of the function of the transplanted kidney.