Effects of oxycodone on vascular endothelial injury in patients undergoing laparoscopic surgery under general anesthesia / 中国基层医药

ABSTRACT

Objective:To investigate the effects of oxycodone on vascular endothelial injury in patients undergoing laparoscopic surgery under general anesthesia.Methods:Eighty patients who received laparoscopic surgery in Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China between September 2018 and September 2019 were included in this study. They were randomly assigned to undergo either intravenous administration of 10 mL 0.9% sodium chloride injection (control group, n = 40) or intravenous administration of 10 mg oxycodone hydrochloride before pneumoperitoneum (observation group, n = 40). Serum levels of norepinephrine (NE), epinephrine (E), heparin sulfate (HS), DPT-1 and vascular cell adhesion molecule-1 (VCAM-1) were measured in each group before pneumoperitoneum (baseline, T 0), at 1 hour after pneumoperitoneum (T 1), 2 hours after pneumoperitoneum (T 2), at the end of pneumoperitoneum (T 3) and at 24 hours after surgery (T 4). Operative time, pneumoperitoneum time and blood loss were recorded in both groups. The incidence of complications (arrhythmia, hypertension, irritability, pruritus, postoperative nausea and vomiting) was recorded. Postoperative Visual Analogue Scale score was compared between the observation and control groups. Results:At T 3 and T 4, serum levels of HS, DPT-1 and VCAM-1 in each group were significantly increased compared with T 0 (all P < 0.05). At T 4, serum levels of HS, DPT-1, and VCAM-1 in the observation group were (15.7 ± 4.8) μg/L, (31.5 ± 6.4) μg/L and (609.7 ± 90.4) μg/L, respectively, which were significantly lower than those in the control group [(18.6 ± 5.4) μg/L, (36.9 ± 7.3) μg/L, (653.2 ± 91.8) μg/L, t = 2.539, 3.518, 2.135, all P < 0.05]. At T 2 and T 3, serum levels of NE and E in each group were significantly increased compared with T 0 (all P < 0.05). At T 2, serum levels of NE and E in the observation group were (124.6 ± 14.5) μg/L and (106.4 ± 11.5) μg/L, respectively, which were significantly lower than those in the control group [(132.9 ± 12.4) μg/L, (111.8 ± 10.4) μg/L, t = 2.751, 2.203, both P < 0.05]. The incidence of postoperative irritability and Visual Analogue Scale score in the observation group were significantly lower than those in the control group (both P < 0.05). Conclusion:Intravenous administration of 10 mg oxycodone hydrochloride before pneumoperitoneum in patients subjected to laparoscopic surgery is beneficial to inhibiting inflammatory reaction, reducing the degradation of endothelial glycocalyx caused by pneumoperitoneum in laparoscopic surgery, and reducing vascular endothelial injury. This study is innovative and scientific.