| Objective: The main aim of the present study was to investigate impact of a single intravenous oxycodone hydrochloride using at different periods for postoperative analgesia in gynecological laparoscopic total hysterectomy.Methods: 60 patients scheduled for gynecological laparoscopic total hysterectomy surgery with general anesthesia were recruited from our hospital,and the patients were respectively classed into stage I or II based on the criterion suggested by American Society of Anesthesiology（ASA）.For each patient,the operation time was less than 120 min,and the average of time was 107.69±6.36 min;Patients were aged between 40 to 62 years,with the average age of 56.2±8.19;the weights ranged from 43 to 75 kg,and its average was 58.5±8.08.The patients were randomly divided into 3 groups.Anesthesia process:when the patient get into the operating room,intravenous penehyclidine hydrochlorise with a dose of 0.1mg/kg was injected for the patient.Anesthesia induction : a consecutive use of imidazole,sufentanil,cisatracurium besilate and etomidate was applied with the associated dose of 0.02-0.03mg/kg,0.3-0.4ug/kg,0.2mg/kg and 0.2mg/kg.After three minutes,the nitrogen was removed and oxygen was supplied with a flow of 6L·min-1,then under the anesthesia covering the dyclonine of 0.06 g,the endotracheal tube was inserted by using ordinary laryngoscope;after auscultating breath sounds of double lung（it should sound clear and symmetrical）,machanical ventilation was conducted by Drager Fabius PLUS XL anesthesia machine,then the tidal volume of 8-10ml·kg-1 and breathing frequency of12 times·min-1 were set with absorption ratio value of 1:2.Maintain anesthesia :propofol(4 to 6mg·kg-1·h-1),dexmedetomidine(0.2-0.5ug·kg-1·h-1),rui fentanyl(0.01-0.02ug·kg-1·h-1),cisatracurium besilate(0.15mg·kg-1·h-1)byMicropump were injected;intravenous drip azasetron 10 mg during the operation.For the patients in group A,a single static oxycodone hydrochloride with a dose of0.1mg·kg-1 was injected 10 min before skin open;for the patients in group B,a single static oxycodone hydrochloride injection with a dose of 0.1mg·kg-1 was injected 10 minutes before the skin susurel;for the patients in group C,a single static oxycodone hydrochloride with a dose of 0.1 mg·kg-1 was injected after remove of the endotracheal tube.Outcomes:（1）The primary outcomes of our study included patient’s visual analogue scale（VAS）score,Ramsay sedation scale score and Bruggman Comfort Score（BCS）and postoperative nausea and vomiting（PONV）score at postoperative1h（T1）,4h（T2）,8h（T3）,12h（T4）,24h（T5）,respectively.（2）Furthermore,adverse reactions like respiratory inhibition,postoperative lethargy and cutaneous pruritus were also collected.Results:（1）Group C had significantly higher VAS score than group A and B for time points T1 and T2（P﹤0.05）,while group B had significant lower VAS score than group A and C（P﹤0.05）,and for the rest of the time points,no significant difference was found（P﹥0.05）.（2）Compared to group C,both group A and B had significant difference of Ramsay sedation scores at T1 and T2（P﹤0.05）,and for the rest of the time point,there was no difference between either of group A and B and group C（P﹥0.05）.（3）Group C had significant lower BCS sore than group A and B at T1 and T2（P﹤0.05）,whereas for the rest of the time points,no significant difference was found（P﹥0.05）.（4）Regarding PONV score and the incidence of other adverse reactions,no significant difference was observed among the three groups（P﹥0.05）.Conclusion : Oxycodone hydrochloride can be applied effectively in laparoscopic total hysterectomy.10 minutes before the skin suture,introvenous injection oxycodone hydrochloride 0.1mg·kg-1 is the best drug delivery way to relieve postoperative pain.It is noteworthy that the sample size is limited;therefore,the conclusion needs to be verified in the further study. |
