Application Of Oxycodone In The Caesarean Section

Objective: 1. To investigate the application of oxycodone in the treatme nt of dragging pain in caesarean section.2. To compare the pain level of the incision pain and contractions pain after caesarean section.Methods: 60 patients were consecutively selected who need selective caesarean section in the Southern Branch of the Sixth People’s Hospital Affiliated to Shanghai Jiaotong University. The patients, with the body weight from 50 to 90 kg, were 18~44 years old, and were classified as I~II grade by the ASA scale.60 cases underwent selective caesarean section were randomly d ivided into three groups:Morphine sulfate injection group(group M, n=20), Oxycodone hydrochloride injection group(group O, n=20) and control group(n=20).Combined spinal epidural anaesthesia was performed in three groups of patients.The Spinal needle was inserted into subarachnoid space through the epidural spinal needle after epidural anaesthesia was performed. 0.5% Ropivacaine Hydrochloride Injection(0.75% Ropivacaine + Cerebrospinal fluid 1ml) was injected into the subarachnoid space, and a block level of T6 was controlled. Morphine sulfate injection with a dose of 5ml(1mg/ml) or Oxycodone hydrochloride injection with a dose of 5ml(1mg/ml) or Normal saline with a dose of 5ml(1mg/ml) was intravenous injected after the delivery of baby, and testing analgesic with a dose of 5ml was intravenous injected when peritoneum was closed. At last, all the patients were given intravenous analgesia postoperatively(PCIA). ① Record the maternal vital signs,general situation(age, height, weight, operation duration, level of anesthesia). ② Visual analogue scales(VAS) of dragging pain were observed and recorded at 5min after injection, 5min after peritoneum closed; VAS of incisional pain and uterine contractions pain at lh, 3h, 6h, 24 h after operation; and Ramsay sedation score(RSS), Bruggrmann comfort scale(BCS), HR, MAP, dosage and pressing numbers of PCIA, and adverse reactions were observed and recorded at 5min after injection, 5min after peritoneum closed, lh, 3h, 6h, 24 h after operation, respectively.Results: There was no significant difference between three groups in age, height, weight, gestational weeks, time of operation(P>0.05); There was no significant difference among three groups in MAP, HR(P>0.05); 2.The VAS score of dragging pain was lower in group O(Oxycodone hydrochloride injection group) compared with that in group M(Morphine sulfate injection group), and much lower than that in control group(P<0.05); The VAS score can obviously reduce 2~4 grade in group O(Oxycodone hydrochloride injection group) for 30 minutes; There was no significant difference among three groups in VAS scoring of contractions pain, RSS scoring and BCS scoring at lh, 3h, 6h, 24 h after operation(P>0.05); The VAS scoring of contractions pain is higher than that of incision pain, especially in multipara(P<0.05); There was no significant difference in the dosage and pressing numbers of PCIA; The occurrence of nausea, vomiting, headache, dizziness in Group M(Morphine sulfate injection group) was more than that in Group O(Oxycodone hydrochloride injection group)(P<0.05); There was no occurrence of skin pruritus and respiratory depression in three groups.Conclusion: Oxycodone was superior to Morphine in the treatment of dragging pain in caesarean section, but its duration of efficacy is short, and it cannot help ease the contractions pain after an operation. The VAS scoring of contractions pain is higher than that of incision pain, especially in multipara.