| Objective:To compare the analgesia effect of oxycodone or sufentanil in patients with elective laparoscopic total hysterectomy.Methods:a total of 60 patients undergoing laparoscopic total hysterectomy under general anesthesia in China-japan Friendship Hospital of Jilin University in 2021 were selected at an elective time,and 60 patients were randomly divided into oxycodone group（group O）and sufentanil group（group S）,with 30 patients in each group.Patients’ conditions were evaluated before surgery.Patients in the three groups were 30-60 years old,body mass index（BMI）was 20-30kg/ m2,ASA grade I to II,basic information such as operation time,intraoperative blood loss and disease condition were similar,and pain sensitivity scale scores were recorded.The three groups were given routine monitoring in the operating room.Group O was given oxycodone 0.1mg/kg,group S was given sufentanil 0.1ug/kg,induction started 5 minutes later,propofol 2.0mg/kg,sufentanil 0.4ug/kg catiataquurium 0.2mg/kg.3min after general anesthesia,endotracheal intubation was performed under visual laryngoscopy,and ventilator was connected.The ventilator parameters were tidal volume 8-10ml/kg,breathing rate 12 times/min,and inhalation-breathing ratio 1: 2.Oxygen flow was 2L/min,intraoperative inhalation of sevoflurane and intravenous pumping of remifentanil were used to maintain BIS40-60,hemodynamic parameters HR and MAP fluctuation ≤±20% base value,pumping speed of remifentanil was adjusted according to intraoperative conditions,and anesthesia and vasoactive drugs were added.Sevoflurane and remifentanil were stopped immediately after the operation,and the tracheal tube was removed after the patient was resuscitated and sent to the anesthesia recovery room（PACU）.Additional rescue analgesic drugs were considered according to the NRS score after resuscitation.Patients in both groups were given the same ratio of sufentanil and granisetron after intravenous controlled analgesia.The following indexes were observed and recorded:1.Age,height,weight,BMI,ASA grade and pain sensitivity scale score of patients in both groups.2.The dosage of remifentanil and vasoactive drugs and the cases of PACU relief analgesia were recorded.3 Riker sedation agitation score（SAS）after extubation was recorded in both groups.4 NRS scores of propofol injection pain in the induction period were recorded.5NRS scores of incision pain,visceral pain and shoulder pain were recorded immediately after extubation,4 hours after surgery,12 hours after surgery and 48 hours after surgery.6 Functional activity scores（FAS）were recorded immediately after extubation,4 hours,12 hours and 48 hours after surgery.7.The number of postoperative adverse reactions such as excessive sedation,respiratory depression,nausea and vomiting were recorded in both groups.Results:1 There was no significant difference between the two groups in terms of Riker sedation agitation score（SAS）,number of cases of PACU rescue analgesia,postoperative shoulder pain NRS score,postoperative functional activity score（FAS）,number of cases of postoperative excessive sedation and respiratory depression2 The NRS scores of incision pain and visceral pain in the induction phase of propofol injection pain,immediately after extubation,4 hours after surgery,and 12 hours after surgery were lower than those in group S（P<0.05）,and the amount of remifentanil in group O was lower than that in group S（P<0.05）,and the number of cases of postoperative nausea and vomiting was lower than that in group S（P<0.05）.Conclusion:For patients undergoing elective laparoscopic total hysterectomy,advance analgesia effect of oxycodone is better than that of sufentanil.Advance administration of oxycodone can significantly reduce the use of remifentanil during operation,which is more advantageous for early postoperative incision pain and visceral pain,and does not increase the occurrence of adverse reactions. |
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