| Objective:To explore the safety and efficacy of oxycodone in endoscopic sinus surgery.Methods:60 patients undergoing endoscopic sinus surgery in general anesthesia,were selected from the Second Hospital of Jilin University from November 2019 to December 2019.The patients were randomly divided into two groups,the experimental group was oxycodone group(O group)and the control group was fentanyl group(F Group),30 cases in each group,male and female unlimited.All the patients were fasted preanesthesia and were used the same intravenous rapid induction of anesthesia.The patients in both groups were given midazolam 0.1mg/kg,cisatracurium 0.2mg/ kg,etomidate 0.2-0.4mg/kg,oxycodone 0.2mg/kg in experimental group and fentanyl 2ug/kg in control group.5 minutes after anesthesia administration,appropriate tracheal tube was selected,tracheal intubation was carried out under the visual laryngoscope,and the ventilator was connected.Then respiratory parameters were adjusted(tidal volume 8ml/ kg,respiratory-tofrequency 12 times / min,respiratory ratio 1:2,oxygen flow 2L/ min).During the operation,propofol 4mg /kg/h and remifentanil 0.2ug/kg/min were infused continuously to maintain.The Bispectral index(BIS)value was maintained in the range of 40-60 during the operation,and the amount of anthemics was adjusted according to the BIS values.After the operation,nitroglycerin was pumped to reduce blood pressure,and the range of blood pressure reduction should not exceed 30% of the basic value.30 minutes before the operation finished,the experimental group was given 0.05mg/kg oxycodone,and the control group was given 0.5ug/kg fentanyl.After the operation,the use of all medications were stopped immediately.All patients were directly sent to the Post Anesthesia Care Unit(PACU).When the patient woke up,removed the tracheal tube,suctioned sputum thoroughly and aspirated oxygen.All the patients were transferred to the ward and routinely monitored for 24 hours.Mean Arterial Pressure(MAP),Pulse Oxygen Saturation(SpO2),Heart Rate(HR)and BIS values were recorded at the time of entering the operating room(T0),intubation(T1),1min after intubation(T2),3min after intubation(T3),5min after intubation(T4).The incidence of choking cough and myoclonus during induction in two groups.We recorded the Visual Analogue Pain Score(VAS)scores at 10 min,30min,1hour,3hours and 6 hours after awakening.The incidence of nausea and vomiting,pruritus,respiratory depression and drowsiness in the two groupsResults:1.There was no significant differences in age,gender,height and weight between the two groups(P > 0.05).2.Compared with group F,MAP and HR at T1 and T2 were significantly lower in group O,and the difference was satistically significant(P <0.05).There was no satistical difference in T0,T3 and T4 between the two groups.There was no significant difference in SpO2 and BIS between two groups(P >0.05)..3.The incidence of choking cough and myoclonus in group O was less than that in group F,but only myoclonus was statistically significant.(P <0.05)4.There was no significant difference in the recovery time and extubation time between the two groups(P >0.05),but there was significant difference in PACU stay time(P < 0.05).5.There was no significant difference in the incidence of nausea,vomiting and respiratory depression between the two groups(P > 0.05),and the incidence of drowsiness was the same.There was no pruritus in both groups.6.There was statistical difference in VAS scores of the two groups at 3 hours after awakening,but there was no statistical difference in VAS scores at other time points(P > 0.05).Conclusion:Oxycodone can be used safely and effectively in anesthesia of endoscopic sinus surgery.Compared with fentanyl,oxycodone has obvious advantages in inhibiting cardiovascular response during intubation,relieving cough and myoclonus,shortening PACU stay time,reducing postoperative pain and not increasing the incidence of adverse reactions... |
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