| Objective: To observe the effect of preemptive analgesia with oxycodone injection on hemodynamics and postoperative analgesia in patients with breast cancer undergoing tracheal intubation and extubation.Methods: We selected the patients who underwent radical mastectomy for breast cancer elective under total intravenous anesthesia,screened by inclusion and exclusion criteria and 40 patients were selected final.They were randomly divided into two groups on average : oxycodone group(group O)and normal saline group(group C).In 5 minutes before the induction of general anesthesia,group O were treated with oxycodone injection 0.1mg/kg,group C were given the same dose of normal saline,the two groups of patients were treated with the same method for anesthesia induction and anesthesia maintenance.Given antiemetic drugs routinely after operation.Recorded the patients' systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),and heart rate(HR)at the time of calming after admission(To),before induction(T1),immediately before intubation(T2),immediately after intubation(T3),1min after intubation(T4),3 min after intubation(T5),5 min after intubation(T6),the end of operation(T7),extubation time(T8),5min after extubation(T9),and 30 min after extubation(T10).Recorded the dosage of each narcotic and the amount of fluid in the operation at the end of anaesthesia.Recorded and compared the two groups of operative time,anesthetic time,postoperative recovery time(from stop drug to call eye open time)and extubation time(from stop drug to take out tracheal tube time).The VAS score and the Ramsay score were performed on the patients at the time of 1h,2h and3 h after operation.If VAS?4,intravenous injection Flurbiprofen ester 50 mg to remedy analgesia.Recorded the number of patients needing remedial analgesia after surgery and the cases of dizziness,nausea,vomiting,respiratory depression,skin pruritus and chills within 24 hours.Results: 1.compared with the basic value of T0,two groups of patients' SBP,DBP,MAP and HR had a certain degree of reduction at the time of immediately before intubation(T2)(P<0.05).After intubation,blood pressure and heart rate of all two groups recovered,but group O increased slightly.In group O,SBP,DBP,MAP and HR at T3-6 were still lower than those of T0.In group C,HR at T3 was significantly higher than that of T0.At the time of 3min after intubation(T5),the SBP,DBP and MAP in group C were significantly higher than those in the group O.2.During the extubation,the blood pressure and heart rate of the two groups increased first and then decreased,and the O group increased slightly.At the time of extubation(T8)and 5min after extubation(T9),SBP,DBP,MAP and HR in group C were higher than those in the group O(P<0.05),and higher than those of T0 too(P<0.05).There was no difference between the two groups at the end of operation(T7)and 30 min after extubation(T10).3.There was no significant difference in the dose of propofol and remifentanil,postoperative recovery time and extubation time between the two groups(P>0.05).There was also no significant difference in Ramsay score and VAS score between the two groups at the time of 1h,2h,and 3h after operation(P>0.05).The two groups show no significant difference in the incidence of postoperative adverse reactions and the frequency of remedial analgesia too(P>0.05).Conclusion: Before the induction of general anesthesia,Intravenous injection of oxycodone 0.1mg/kg can safe and effective to inhibit the cardiovascular response to endotracheal intubation and extubation,maintain the hemodynamics stable.It did not affect the postoperative recovery and extubation of short and small surgery.It also did not increase the postoperative adverse reaction.So It is worth popularizing in clinical practice. |
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