The Clinic Study Of Oxycodone Combined With Ketorola For PCIA After Caesarean Section

Objective:To evaluate the efficacy and safety of oxycodone hydrochloride injection for patient-controlled intravenous analgesia?PCIA?in patients after caesarean section.Methods: Forty patients undergoing elective cesarean section under spinal anesthesia were randomly divided into 2groups?n=20each?: Dozocine group?group D?,Oxycodone Group?group O?.All patients comply with following condition: ASAI-II grade,full term and single birth patients,20-38 years old,weight from 60 kg to 80 kg,exclusive pregnancy complication,spinal anesthesia contraindication,history of mental illness and history of opioid dependence.Before operation,the patients and relatives were educated the approach of PCA,announcements and explained VAS score.10 mg bupivacaine was used for spinal anesthesia,and anaesthesia level was controlled below T₆ level.Each maternal was given PCIA after operation.Group D: dozocone 30 mg +ketorolac 180 mg + tropisetron 5mg +0.9%NS=100 ml,Group O: oxycodone 30 mg +ketorolac 180 mg + tropisetron 5mg +0.9%NS=100 ml,Visual analogue scale?VAS?scores,Ramsay scores,the times of PCA compressions,respiratory depression,nausea,vomiting,pruritus and other adverse reactions were also recorded at 1h?T₁?,4h?T₂?,12h?T3?,24h?T₄?,36h?T₅?,48h?T₆?after operation,and the lactating time were also recorded.Results:?1?The patients age,weight,body height,gestational weeks were no statistical difference?P>0.05?.?2?The rest VAS pain score in both groups at T₁,T₅,T₆ were no significant different?P>0.05?,and the rest VAS pain score in group D were higher at T₂,T3,T₄ than that in group O.The dynamic VAS pain score in both groups at T₁,T₂,T₅,T₆ were no significant different?P>0.05?,and the dynamic in group D at T3 and T₄ were higher than that in group O,the difference has statistical significant?P<0.05?.?3?From T₁ to T₆,the consumption of pressing times of analgesia in group D were higher than group O?P<0.05?;From T₁ to T₄,the consumption of pressing times of analgesia in group D were higher than group O?P<0.05?;but from T₄ to T₆,the comsuption of pressing times in both groups were no significant different?P>0.05?.In both groups,the consumption pressing times from T₁ to T₄ were significant more than that from T₄ to T₆?P<0.01?.?4?Ramsay sedation score between two groups has no significant differert?P>0.05?.?5?The incidence of postoperative nausea and vomiting lower in group D,but there is no significant different?P>0.05?.?6?Each group patients were visited to find there was no respiratory depression,pruritus and other adverse reactions occurred.?7?The time of lactating has no significant difference between both groups.Conclusion:In the clinic study of oxycodone and dezocine combined with ketorolac for PCIA in patients after caesarean,both methods have a good analgesic effect and safety.But oxycodone combined ketorolac can provide a better analgesic effect in the earlier first24 hours after operation when the patients feel pain seriously,and the incidence of side effect and time of lactating are similar.