Effect of oxycodone on early recovery after microvascular decompression on treating trigeminal neuralgia / 临床麻醉学杂志

ABSTRACT

Objective To evaluate the efficacy and safety of oxycodone in patients undergoing microvascular decompression in treating trigeminal neuralgia and oxycodone versus sufentanil on early recovery after microvascular decompression in treating trigeminal neuralgia.Methods Eighty-six patients (38 males, 48 females, aged 18-65 years, BMI 18-30 kg/m2, ASA physical status Ⅰ or Ⅱ) scheduled for microvascular decompression in treating trigeminal neuralgia, were randomly divided into either oxycodone group (group O) and sufentanil group (group S) using a random number table, n=43 in each group.All patients received combined intravenous-inhalational anesthesia, as well as oxycodone 0.3 mg/kg injected intravenously in group O, sufentanil 0.4 μg/kg injected intravenously in group S for anesthesia induced analgesia.When the epidural was closed, oxycodone 0.07 mg/kg was injected intravenously in group O, sufentanil 0.1 μg/kg was injected intravenously in group S.On preoperative day 1 and 4, 24, 48 hours after surgery, numeric rating scale (NRS) was used to assess the incision pain and facial pain.When NRS scores≥4, oxycodone 3 mg in group O and sufentanil 5 μg in group S was injected intravenously as rescue analgesic.On preoperative day 1 and 3 days after surgery, the global QoR-40 aggregating score was used to assess the quality of patients recovery.The requirement for rescue analgesics was recorded.The occurrences of nausea and vomiting were recorded.Extubation time and discharge were recorded.The other adverse events (bradycardia, dysuria, dizziness and pruritus) were recorded.Results Compared with group S, the physical comfort score, the emotional state score, the psychological support score, the pain score and the global QoR-40 scores were higher in group O 3 days after surgery (P<0.05).Compared with group S, the incidence of nausea and vomiting was significantly lower in group O (20.9% vs 37.2%) (P<0.05).Conclusion In surgery less than 5 hours of microvascular decompression on treating trigeminal neuralgia, oxycodone 0.3 mg/kg can be safely and effectively used for anesthesia induction, oxycodone 0.07 mg/kg and 3 mg can be respectively used for postoperative prophylactic analgesia and remedial analgesia.Compared with sufentanil, oxycodone can improve the quality of recovery during the early period after microvascular decompression on treating trigeminal neuralgia, and decrease the incidence of nausea and vomiting.