Effect Of Oxycodone Hydrochloride In The Perioperative Pain Management Of Patients Undergoing Burn Scab Cutting And Skin Grafting

Objective:A randomized controlled double-blind study was applied to systematically evaluate the efficacy and safety of oxycodone hydrochloride for the management of perioperative general anesthesia in patients undergoing burn scab cutting and skin grafting.Methods:Eighty patients with general anesthesia in the Fourth Medical Center of PLA General Hospital from March to September 2022 were randomly divided into sufentanil group and oxycodone hydrochloride group,including 44 patients in sufentanil group and 36 patients in oxycodone hydrochloride group.Anesthesia induction in the sufentanil group was performed using sufentanil（0.2μg/kg）,midazolam（0.02 mg/kg）,etomidate（0.1 mg/kg）,propofol（1 mg/kg）and rocuronium（1mg/kg）;Anesthesia was maintained with intravenous inhalation balanced anesthesia.Additional sufentanil:5μg/time;A patient-controlled intravenous analgesia pump（Patient Controlled Intravenous Analgesia,PCIA）was given to sufentanil（2μg/kg）+dexamethasone（10mg）;Oxycodone group oxycodone hydrochloride was induced by oxycodone hydrochloride（0.08 mg/kg）,and the rest of induction and maintenance drugs were the same as in the sufentanil group.Additional intraoperative oxycodone hydrochloride（2mg/time）.PCIA was also applied for postoperative analgesic management with oxycodone hydrochloride（0.6 mg/kg）+dexamethasone（10 mg）.Record the MAP,HR,and their rate of change including basic data（T₁）,entering the operation room（T₂）,2 min after anesthesia induction intubation（T₃）,surgical skin removal（T₄）,skin grafting（T₅）,exiting the operation room（T₆）.The Self-rating Anxiety Scale（SAS）scores,Visual Analogue Scale（VAS）for anxiety and pain,and the occurrence of adverse reactions such as postoperative dizziness,nausea and vomiting were also recorded.Results:（1）There were no statistically significant differences between the two groups in terms of gender,age,BMI,burn area,number of operations,initial operation after burn,and ASA grade（p>0.05）;Comparison of the amount of intraoperative medication dosage in both groups,such as propofol,remifentanyl and sevoflurane,the amount of fluid access（crystalloid colloid,blood loss,blood transfusion and urine volume）,operation time,anesthesia time,time from the end of surgery to extubation,and time from extubation to exit from the room,were no statistically differences respectively（p>0.05）;Compared to the oxycodone hydrochloride group,Higher frequency of perioperative vasoactive drugs in the sufentanil group,the difference was statistically significant（p<0.05）;（2）The comparison of MAP and HR at different time point between the two groups revealed that the differences were not statistically significant（p>0.05）;however,the intraoperative MAP fluctuated more in the sufentanil group compared with the Oxycodone group,and their MAP change rate（△MAP）was higher.Compared to the MAP entering the operation room（T₂）group,△MAP of the two group was statistically significant（p<0.05）;（3）Compared with sufentanil group,patients in the Oxycodone group had lower postoperative pain VAS scores at 24 h and 48 h,respectively[1.0（0.0,2.0）vs 2.0（1.0,3.0）,0.0（0.0,1.0）vs 1.0（0.0,2.0）]（p<0.05）,and VAS-a scores and SAS scores in both groups,were not statistically different,respectively（p>0.05）;（4）Compared with oxycodone group,higher postoperative adverse effects revealed in sufentanil group,and the difference was statistically significant（P<0.05）.Conclusion:Oxycodone hydrochloride can be used in the management of burn patients after scab cutting and skin grafting,with more stable circulation,better analgesia and less adverse effects.