The Clinical Observation Of Oxycodone Combined With Dexmedetomidine On PCIA After Renal Transplantation

ObjectiveTo systemic evaluate the efficacy and safety of oxycodone combined with dexmedetomidine of PCIA on renal transplantation patients.MethodsNinety American Society of Anesthesiologists physical status?or?patients of both sexes,aged 28-51 years,weighing 53-76kg,scheduled for elective allograft renal transplantation under general anesthesia,were divided into 3 groups?n=30each?using a random number table:sufentanilgroup?group S??oxycodone group?group O?and oxycodone mixed with dexmedetomidine group?group OD?.PCIA was carried out at the end of surgery.GroupS:sufentanil?2.0?g/kg?and ondansetron 8mg;GroupO:oxycodone?1.0mg/kg?and ondansetron 8mg;GroupOD:oxycodone?0.6mg/kg?,dexmedetomidine?5?g/kg?and ondansetron 8mg;all compounds were dissolved in 100ml 0.9%saline.Parameters:Infusion speed 2ml/h;PCIA dosage 0.5ml each time;Lock time:15mins.The observation and analysis of general data and intraoperative data indicators of 3 groups of patients were recorded.The venous blood was collected at 10min before anethesia,4h,12h,24h,48h after operation,and the levels of blood endothelin?ET?,urea nitrogen?BUN?and creatinine?Cr?were determined by radioimmunoassay method,and the concentrations of plasma norepinephrine?NE?and epinephrine?E?were determined by high perfomance liquid chromatography-electrochemical method,At the same time,the mean arterial pressure?MAP?,heart rate?HR?,pulse oximetry?SpO₂?and urine were recorded at each time.The amount of pain,sedation,mood,and sleepquality were scored,and the incidence of adverse reactions such as nausea,vomiting,dizziness,respiratory depression,and bladder irritation were recorded.The patient's satisfaction with PCIA was evaluated on the third postoperative day.ResultsThere was no significant difference between the general data and the intraoperative data indicators of the three groups?P>0.05?.Compared with group O and S,the levels of hemodynamics?MAP,HR?and stress hormones?ET,E,NE?in OD group were more stable at T12h,24h,48h?P<0.05?.The BUN,Cr and Urine were better than preoperative in three groups?P<0.05?.Compared with group S and O,The functional indicators of OD group were significantly improved at T12h,24h and 48h?P<0.05?;The M-VAS score,Ramsay sedation score,sleep and emotional scores within 48 hours after operation were significantly better than those in S group and O group?P<0.05?.Compared with groupS,the incidence of nausea,vomiting and catheter-induced bladder irritation?CRBD?in O and OD groups was significantly lower?P<0.05?.Compared with the O group,the incidence of nausea,vomiting in OD was significantly lower?P<0.05?.After comprehensive evaluation on the third day after operation,patients in the OD group showed higher satisfaction with PCIA than those in group S and O?P<0.05?.ConclusionOxycodone mixed with dexmedetomidine for PCIA after renal transplant-ation can reduce the dosage of opioids,and has better analgesic effect with fewer adverse reactions,effectively promote the recovery of renal function and improve patient's satisfaction.