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Research Article

羟考酮在全髋关节置换术中镇痛效果和安全性的初步研究

卷 29, 期 21, 2022

发表于: 30 March, 2022

页: [3806 - 3814] 页: 9

弟呕挨: 10.2174/0929867329666220126125256

价格: $65

摘要

目的：本研究旨在评估全髋关节置换术（THA）椎管阻滞过程中服用1 mg和0.5 mg羟考酮的镇痛效果和安全性。 患者和方法：42名年龄在59-81岁的美国麻醉学学会（ASA）II-III级THA患者被纳入研究。所有患者均接受脊髓阻滞麻醉，布比卡因0.5%脊髓重2.5 ml，0.5ml盐酸羟考酮 1.0 mg（A组；n=28）或0.5 mg（B组；n=14）。在手术期间，每位患者静脉输注2-4 mg/kg/h丙泊酚进行镇静。他们在手术结束后的晚上8点和早上8点静脉注射酮洛芬100毫克，之后每12小时注射一次推荐剂量。皮下注射5 mg吗啡作为抢救性镇痛剂，并记录吗啡使用时间。手术后，使用11点数字评分量表（NRS）评估疼痛强度（患者报告时），并监测不良反应的发生率。采集血样以测定血清羟考酮、去甲羟考酮和布比卡因水平。 结果：A组的镇痛时间为9.6±5.6小时，B组为7.3±1.9小时，两组间无差异（P=0.179）。A组的平均NRS疼痛评分为4.5分，B组为4.2分。A组有三名患者可检测到羟考酮水平：两名患者<7.1 ng/ml，1名患者的脊髓阻滞诱导麻醉不成功，因此他/她进行了全身麻醉（该患者被排除在分析之外）。4名B组患者的单值<5 ng/ml。所有患者的去甲羟考酮水平均无法检测到，布比卡因水平为70-300 ng/ml。关于不良反应，1名患者出现低血压，1名患者出现心动过缓，1名患者出现瘙痒。

关键词: 不良反应，麻醉，镇痛，鸦片类，羟考酮，疼痛，治疗。

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