Change Of Hemodynamics And Stress Reaction Of Oxycodone Hydrochloride During Tracheal Intubation On Clipping Of Intracranial Aneurysm

PurposeWe aim to observe the effect of oxycodone hydrochloride acting on hemodynamics and stress reaction during tracheal intubation on clipping of intracranial aneurysm, and to explore the safety and efficacy of oxycodone.MethodsEighty patients who undergoing selective clipping of intracranial aneurysms were enrolled in the study in China-Japan Union Hospital of Jilin University between May in 2015 to March in 2016. The patients are randomly assigned to four groups:control group(Fentanyl group: group F(n=20)), experimental groups(Oxycodone groups: group O1(n=20),group O2(n=20),group O3(n=20)). After the radial arterial and peripheral venous cannulation, and the establishment of standard monitoring,systolic blood pressure(SBP) 、 diastolic blood pressure(DBP) 、 pulse oxygen saturation(Sp O2) 、 electrocardiogram(ECG) 、 end-tidal carbon dioxide partial pressure(Pet CO2)、bispectral index value(BIS value) 、temperature and central venous pressure(CVP) were recorded. At the beginning of anesthesia induction, the patients in experimental groups were received oxycodone with the different doses: group O1:0.25mg/kg, group O2: 0.30mg/kg, group O3: 0.35mg/kg. The patients in group F were received fentanyl with the dose of 0.003mg/kg. Then all the patients were treated with same anesthesia induction program: midazolam with the dose of0.05mg/kg, cisatracurium besylate with the dose of 0.2mg/kg, propofol with the dose of 2mg/kg. Mean arterial pressure(MAP) 、 heart rate(HR) 、 pulse oxygen saturation(Sp O2) 、 BIS value were recorded at different points of time: before the induction of anesthesia(T0), the moment before tracheal intubation(T1), 1 min after the tracheal intubation(T2), 3 min after the tracheal intubation(T3), 5 min after the tracheal intubation(T4). The plasma concentrations of epinephrine and norepinephrine were detected at the time points of T0、T2、T4.ResultsThe MAP of the four groups shows that there is no statistically significance at the time points of T0~T1(P>0.05). At the points of T2?T4, the MAP in the four groups shows the increasing trend compared to the points of T1, and the MAP in experimental groups are lower than that in group F. The comparisons between the each experimental groups and group F show statistically significances(P<0.05), but the comparisons between the each two experimental groups show no statistically significance(P>0.05). At the points of T2?T4, the HR in the four groups shows no statistically significance(P>0.05). The pulse oxygen saturation(Sp O2) of all the patients were maintained at more than 96% during induction of anesthesia. The BIS values in the points of T1?T4 were lower than T0.Comparisons between the fourgroups show that there is no statistically significance in BIS value at each time points(P>0.05). Comparisons between the four groups show that there is no statistically significance in the plasma concentrations of epinephrine and norepinephrine at the time points of T0(P>0.05). The plasma concentrations of epinephrine and norepinephrine of the four groups at the time point of T2 shows an increasing trend compared to the time point of T0. At the time point of T2 and T4, the plasma concentrations of epinephrine and norepinephrine of group F is higher than experimental groups, and the comparison of the two groups shows statistically significance(P < 0.05), but the comparisons between the each two experimental groups show no statistically significance(P>0.05).ConclusionIn the tracheal intubation during induction of anesthesia on clipping of intracranial aneurysm, the application of oxycodone hydrochlorides can inhibit the fluctuation of MAP and the increasing of the plasma concentrations of epinephrine and norepinephrine.