The Effect Of Oxcycodone In Patients Undergoing The Transurethral Resection Of The Prostate With Patient-controlled Analgesia And Its Impacts On Substance P And 5-HT

Objective To study the effect,adverse reactions and impacts of plasma substance P and5-hydroxytamine of oxycodone on postoperative pain in patients with patient-controlled intravenous analgesia(PCIA)after transurethral vaporization of the prostate.Methods one hundred and twenty patients undergoing transurethral vaporization of the prostate were divided into three equal groups(group O,group S and group H)according to the random number table method.All patients were treated with intravenous analgesia after surgery.The concentration for PCIA:Group O was administered a 100 ml-mixture of oxycodone(0.8mg/kg),5mg of tropisetron and a normal saline solution;group S was administered a 100 ml-mixture of sufentanil(2?g/kg),5mg of tropisetron and a normal saline solution;group H was administered a 100 ml-mixture of hydromorphone(0.2mg/kg),5mg of tropisetron and a normal saline solution with a basal infusion of 2ml/h,bolus dose of 0.5ml,and lockout interval of 15 minutes.The loading does of 5ml liquid in analgesia pump was administered to each patient 10 min before the end of surgery and then started with patient-controlled analgesia for 48 h.If patients complained severe pain,we recommended them to press the button or administered rescue analgesics and make a note.The patient's general situation,ASA classification,operation time,the MAP,HR,SPO2 before anesthesia,postoperative immediate,6 hours,12 hours,24 hours and 48 hours after the surgery were recorded.The levels of substance P and serotonin(5-HT)in peripheral blood were measured before anesthesia and 12 hours,24 hours and 48 hours after surgery.Adverse reaction and the number of additional analgesia,the incidence of bladder spasm,PCA effectively press times,VAS scores,Ramsay scores at different time-points after surgery were evaluated and recorded.Results 1 There were no significant differences about age,weight,ASA classification,surgery time between three groups.2 The differences between three groups of HR,MAP,Sp O2,VAS scores and Ramsay scores at every time-points were not statistically significant.3 Plasma substance P and 5-hydroxytamine increased at 12,24,48 hours after surgery compared with before anesthesia(P<0.05),group O had lower plasma substance P and 5-hydroxytamine at 12,24,48 hours than group S and H(P<0.05).4 PCA effectively press times,the number of additional analgesia,and the incidence of bladder spasm in group S and H were increased compared to group O(P<0.05).4 Group S,H had higher incidence of nausea,vomiting,dizziness and drowsiness than group O(P<0.05);There were no significant differences in other side effects.No respiratory depression was observed in all groups.Conclusions 1 Oxycodone may effectively relieve postoperative pain after TURP and had little effect to respiratory and circulatory.2 Oxycodone may inhibit the elevation of subtance P and 5-hydroxytamine.3 Oxycodone for postoperative analgesia had less side effects.