A Single Intravenous Injection Of Oxycodone Hydrochloride In The Treatment Of Acute Post-operative Pain After Laparoscopic Rectal Tumor Resection

Objective： Compare the differences between a single dose ofoxycodone and fentanyl which is inject to the patients with laparoscopicresection of rectal tumor on acute postoperative pain and the quality ofawakening.Methods：59patients, ASA I-II,26males and33females, aged40-76years old,scheduled for Laparoscopic rectal tumor resection,wererandomly divided into two groups: oxycodone hydrochloride injectiongroup (O group n=30) and fentanyl injection group (F group n=29). Onepatient in fentanyl group Prince-Henry score was4points, additionalanalgesics was given, exit test early. oxycodone0.1mg/kg (salinedilution of1mg/ml) or fentanyl1ug/kg (saline dilution of10ug/ml)was injected intravenously at the end of surgery. Extubating the trachealwhen the patients were awake and their reflex activity were recovered,Pations intake air after extubation, when SpO2<90%, inhalation ofoxygen(50%) and record. Assessing the OAA/S sedation grade andPrince-Henry postoperative pain scores when extubation and5min,10min,15min and20min after extubation,When Prince-Henry score≥3,there occours acute pain. When the OAA/S sedation classified as0or Prince-Henry score of4, the case removed, don’t participate in evaluation of results.Each group received patient-controlled intravenousanalgesia(PCIA)20min after tracheal extubation.The PCIA (sufentanil2ug/kg, ondansetron12mg) pump was set up with a5ml loading dose,a0.5ml bolus does,a15min lockout interval and background infusion ata rate of2ml/h. Recorded the anesthesia time, operation time, recoverytime of spontaneous breathing, extubation time and recovery time (thetime from stopping use anesthetics to answer simple questionscorrectly).Recorded HR, SpO2and mean arterial pressure at the end ofoperation, extubation and5min,10min,15min and20min afterextubation.Results：The difference between the two groups of gender, age, bodyweight, BMI, duration of anesthesia and surgery time was notstatistically significant. The spontaneous breathing recovery time,extubation time and recovery time of Oxycodone group were shorterthan fentanyl group, the difference was statistically significant (p <0.05).Repeated measures analysis of variance showed: the heart rate and meanarterial blood pressure trends of two group is consistent during theending of surgery to a period of20minutes after extubation. The rate ofpostoperative acute pain of both group had eased, but the Prince-Henrypain scores of F group were higher than O group at each time point,there is more patients with postoperative acute pain than the O group (7:2)； OAA/S sedation grade were lower than O group,the number ofpostoperative sedation is more than O group (9:1); Oxygen saturationdecrease is lower than O group, the number of SpO2≤90%is more than O group (5:1), SpO2were improved after inhalation of oxygen. Theincidence of nausea and vomiting were similar between two groups, nostatistically significant difference.Conclusion：A single intravenous injection of oxycodone0.1mg/kg isbetter than fentanyl1ug/kg to prevent the acute postoperative pain afterLaparoscopic rectal tumor resection at the end of theoperation,oxycodone with lower incidence of sedation and respiratorydepression is more secure used in the recovery period of generalanesthesia.