标题：不同剂量羟考酮复合丙泊酚对腹腔镜下胆囊切除术患者血氧饱和度及血流动力学参数的影响

      作者：张柳莉，张洁，郁文    复旦大学附属华山医院北院麻醉科，上海 201900

      卷次： 2021年32卷15期

      【摘要】 目的 探讨不同剂量羟考酮复合丙泊酚对腹腔镜下胆囊切除术患者血氧饱和度及血流动力学参数的影响。方法 选择2018年2月至2020年9月在复旦大学附属华山医院北院行择期腹腔镜下胆囊切除术的96例患者为研究对象，按随机数表法分为ABC三组，每组32例。A组静脉缓慢推注盐酸羟考酮注射液0.04 mg/kg+丙泊酚注射液1.5 mg/kg诱导麻醉，B组以静脉推注羟考酮注射液0.08 mg/kg+丙泊酚注射液1.5 mg/kg诱导麻醉；C组以静脉推注羟考酮注射液0.12 mg/kg+丙泊酚注射液1.5 mg/kg诱导麻醉，术中均以丙泊酚4~6 mg/(kg·h)持续泵注维持麻醉至手术结束。比较三组患者的苏醒时间、苏醒质量、疼痛程度、血氧饱和度、血流动力学参数和不良反应发生情况。结果 三组患者的苏醒时间比较，A组>B组>C组，Stward苏醒评分比较，B组>A组，C组>A组，视觉模拟评分(VAS)比较，A组P<0.05)；C组患者手术5 min后(t1)及手术苏醒10 min后(t2)的血氧饱和度(SpO2)、平均动脉压及心率明显低于B组及A组，B组又明显低于A组，差异均有统计学意义(P<0.05)；C组患者的不良反应发生率为21.88%，明显高于B组的6.25%及A组的3.13%，差异有统计学意义(P<0.05)。结论 不同剂量羟考酮复合丙泊酚对腹腔镜下胆囊切除术患者的麻醉效果具有显著的影响，静脉推注羟考酮注射液0.08 mg/kg+丙泊酚注射液1.5 mg/kg诱导麻醉可提供满意的镇痛效果且对患者的SpO2及血流动力学参数影响更小，并可降低不良反应发生率。
      【关键词】 羟考酮；不同剂量；丙泊酚；复合麻醉；腹腔镜下胆囊切除术
      【中图分类号】 R657.4 【文献标识码】 A 【文章编号】 1003—6350（2021）15—1962—03

Comparative analysis of the effects of different doses of oxycodone combined with propofol on patientsundergoing laparoscopic cholecystectomy.
ZHANG Liu-li, ZHANG Jie, YU Wen. Department of Anesthesiology, NorthCampus, Huashan Hospital Affiliated to Fudan University, Shanghai 201900, CHINA
【Abstract】 Objective To explore the effects of different doses of oxycodone combined with propofol on bloodoxygen saturation and hemodynamic parameters in patients undergoing laparoscopic cholecystectomy. Methods Nine-ty-six patients who scheduled for laparoscopic cholecystectomy were selected in North Campus, Huashan Hospital Affili-ated to Fudan University from February 2018 to September 2020 and divided into three groups by random number table,with 32 patients in each group. Group A received oxycodone hydrochloride injection 0.04 mg/kg and propofol injection1.5 mg/kg, group B received oxycodone hydrochloride injection 0.08 mg/kg and propofol injection 1.5 mg/kg, and groupC received oxycodone hydrochloride injection 0.12 mg/kg and propofol injection 1.5 mg/kg. Propofol 4-6 mg/(kg·h)was used to maintain anesthesia until the end of operation. The recovery time, recovery quality, pain degree, blood oxy-gen saturation, hemodynamic parameters, and occurrence of adverse reactions were compared between the two groups.Results Comparison between the three groups showed statistically significant differences in the following indexes (P<0.05): recovery time: group A>group B>group C; Stward recovery scores: group B>group A, group C>group A; VASscores: group AP<0.05). The incidence of adverse reactions in group C was21.88%, which was higher than 6.25% in group B and 3.13% in group A (P<0.05). Conclusion Different doses of oxy-codone combined with propofol have a significant effect on the anesthesia effect of laparoscopic cholecystectomy. Theintravenous bolus injection group of oxycodone injection 0.08 mg/kg+propofol injection 1.5 mg/kg can induce anesthe-sia. It provides satisfactory analgesia and has less impact on SpO2 and hemodynamic parameters of patients, and can re-duce the incidence of adverse reactions.
      【Key words】 Oxycodone; Different doses; Propofol; Combined anesthesia; Laparoscopic cholecystectomy