Advantages Of Hydroxycodone In The Application Of Ophthalmic Pediatric Anesthesia

ObjectiveTo explore the feasibility of oxycodone hydrochloride injection in general anesthesia induction in pediatric strabismus surgery and to provide more guidance and choice for clinical work.MethodsFrom October 2019 to January 2020,80 children aged 4-12 years and weighing 20-60 kg ASA grade Ⅰ-Ⅱ who were scheduled to undergo strabismus correction under general anesthesia in Henan people’s Hospital of Henan University were randomly divided into two groups(by Random number table method): sufentanil group(group S)and oxycodone group(group O).All children were guaranteed to fast for 8 hours and water for 3 hours before operation.After entering the operating room,the children were monitored routinely(ECG monitoring,non-invasive blood pressure,blood oxygen saturation),and the peripheral venous pathway was opened.The anesthesia induction regimen was midazolam injection0.03 mg / kg,oxycodone hydrochloride injection 0.1mg / kg,propofol 1.5mg / kg,and cis atracurium0.2mg/kg in group O(oxycodone hydrochloride 0.1mg / kg,propofol 1.5mg / kg,cis-atracurium).Sufentanil injection 0.3 ug / kg was injected intravenously in group S,and the method and sequence of administration were the same as those in group O.After induction,the laryngeal mask was inserted and the ventilator was mechanically ventilated.The ventilator parameters were set as follows: tidal volume kept at6: 8ml / kg,respiratory rate 12-18 / min,oxygen flow 2L / min;During the operation,the simple inhalation anesthesia was maintained,the volatile tank was adjusted to keep 2% sevoflurane for inhalation maintenance,all drugs were stopped at the end of the operation,and the(PACU)was sent to the monitoring and treatment room after anesthesia for resuscitation,waiting for the child to be able to breathe independently,stable circulation,recovery of consciousness,recovery of laryngeal protective reflex,conscious consciousness,and remove the laryngeal mask after being able to act in accordance with instructions.The general condition,operation time,extubation time,PACU time,nausea and vomiting,respiratory depression and other adverse reactions were recorded in group O and group S,and the mean arterial pressure,blood oxygen saturation and heart rate were compared between the two groups beforeanesthesia induction(T1),after administration of anesthesia induction drugs(T2),immediately after laryngeal mask insertion(T3),at the beginning of operation(T4)and at the end of operation(T5).The changes of pupil diameter before and after induction,the occurrence of restlessness,nausea and vomiting,respiratory depression and other adverse reactions during general anesthesia induction and recovery period of general anesthesia were recorded,and the conclusions were obtained by statistical analysis of the data of each index.Results(1)comparison of general data between the two groups: there was no statistical difference in preoperative general conditions,including sex,age and body weight between the two groups.(2)comparison of hemodynamics between the two groups: compared with the T1 time at the basic level,the MAP and HR of the two groups decreased significantly at T2,and the difference was statistically significant.Comparison between the two groups: there was no significant difference in MAP and HR at T1 time between group O and group S(P > 0.05).At T2 time,the MAP and HR of the two groups decreased,especially in the S group,and the difference was statistically significant(P < 0.05).At the two time points of T3 and T4,the values of O group and S group increased significantly,but the comparison between the two groups had no statistical significance(P > 0.05).Although the change of blood pressure in group S was more significant at T5,there was no significant difference between the two groups(P > 0.05).(3)comparison of preoperative pupil diameter between the two groups: there was no significant difference in preoperative pupil diameter between the two groups(P > 0.05).The pupil diameter of the two groups decreased significantly compared with that of the),O group(P < 0.05),and the pupil diameter decreased significantly in the S group(P < 0.05.There was a significant difference in the pupil diameter between the S group and the S group(P < 0.05).(4)comparison of postoperative conditions between the two groups:there was significant difference in the incidence of postoperative nausea,vomiting and respiratory depression between group O and group S(P < 0.05).There was no significant difference in postoperative pain score and PAED score between the two groups.(5)there was no significant difference in operation time,extubation time,PACU time and blood oxygen saturation between the two groups(P > 0.05).ConclusionOxycodone hydrochloride injection can produce the same effect as traditional opioids in generalanesthesia induction in children strabismus surgery,and provide good analgesic effect during the operation.the incidence of adverse reactions such as respiratory inhibition,nausea,vomiting and restlessness after operation is lower than that of sufentanil,which can be used safely and improve the perioperative safety and comfort of children.