The Clinical Observation Of Dexmedetomidine Combined With Oxycodone For Patient-Controlled Analgesia After Laparotomy

Objective: The aim of this study was to observe the effect of combining dexmedetomidine and oxycodone for intravenous patient controlled analgesia after laparotomy.Methods: Eighty patients undergoing elective open abdominal surgery were randomly divided into four groups(n=20):oxycodone1.0mg˙kg-1(groupO);oxycodone1.0mg˙kg-1+dexmedetomidine0.05ug˙kg-1h-1(group-D1);oxycod one0.75mg˙kg-1+dexmedetomidine0.05ug˙kg-1h-1(group-D2);oxycodone0.5mg˙kg-1+dexmedetomidine0.05ug˙kg-1h-1(group-D3).All group were filled with normal saline(NS) to 100 ml( background infusion at 2 ml/h with a bolus dose of 0.5 ml and a 15 min lockout interval).All groups received oxycodone0.1 mg˙kg-1.20 minutes before the end of surgery given tropisetron 5 mg.The MAP and HR of T1,T2,T3,T4 were recorded respectively in three groups.After the operation, a blinded observer assessed pain using visual analogue scale(VAS score),the level of sedation(Ramsay score),postoperative nausea and vomiting score at 2, 6, 24, 48, 72 h were recorded.Side effects include dizzy shivering headache pruritus also were recorded respectively.Results: Compared with group O,the VAS score during coughing was significantly increased in group D3 at 2h、6h、24h、48 h.Compared with group O,there was a significant difference at rest in the time of 2h、6h、24h、48h.Sedation levels of the patients were assessed based on the Ramsey sedation scale.There was no significant difference on Ramsey sedation scale between each group.There was no statistically significant difference between each group at the time of T1, T2, T3, T4 in the points of MAP and HR(P>0.05).Patients needed additional analgesic(intramuscular tramadol 0.1g)were significantly increased in group D3.Side-effects such as vomiting,headache, shivering, pruritus, and respiratory depression in each group were not significantly different. However, the patients in o and D1 group experienced more nausea after operation compared to D2.Compared to O group,there was a significant difference in MAP at the times of 6h、24h、48h in D3 group.Compared to the O group,there was a significant difference in HR at the times of 2h、6h、24h in the D2 group.The stisfaction were significantly better in group D2.Conclusion: Oxycodone can be used for postoperative analgesia in patients withlaparotomy.moreover,oxycodone 0.75mg˙kg-1 combined with dexmedetomidine 0.05ug˙kg-1h-1 for intravenous patient- controlled analgesia after open abdominal surgery could get perfect analgesic and proper sedation.