Clinical Application Of Oxycodone With Dexmedetomidine For Patient-controlled Analgesia After Laparoscopic Radical Resection Of Colon Cancer

Objective:We prepare to investigate the comparision oxycodone combined with dexmedetomidine,sufentail and sufentail combined with dexmedetomidine for patient-controlled analgesia after laparoscopic radical resection of colon cancer.Methods:Choose 60 patients with ASA(American Standards Association)I – II,no matter men or women,aged 55-75,who accept the laparoscopic colon radical surgery during the elective general anesthesia.All patients received the same style of patient controlled intravenous analgesia after surgery(background infusion 2 ml/h,single drug dose 0.5 ml,locking time 15 minutes,Added to the 100 ml with 0.9% saline water).Using the random number table method,60 patients were divided into three groups(S group,the SD group,the OD group,n = 20),the group S: sufentanil 2.0 ug/kg;SD group: sufentanil 2.0 ug/kg and dexmedetomidine 0.05 ug/kg· h;OD groups: oxycodone 0.8 mg/kg and dexmedetomidine 0.05 μg/kg· h.After tracheal extubation,all patients with the similar standard,which NRS being four,open the analgesia pump.The targets will be recorded:NRS scores and Ramsay scores at five different moments(1,6,12,24,48h)after analgesia at rest and movement time(cough),the total times of self-controlled analgesia and remedial analgesia during the 48 hours after analgesia,the occurrence of nausea,vomiting,headache,dizziness,chills,itchy skin and other adverse reactions of the situation,the incidence of postoperative delirium within three days and the patients’ satisfaction.Results:There is no significant difference that patients age,height,body weight,body mass index(BMI)of three groups.For the NRS scores in resting,compared with S group,SD group(T2 and T4)has statistically difference(P < 0.05),however,OD group has statistical significance in each period(T1-T5),and compared with SD group,OD group has statistically significance during T2,T3 and T5.For the NRS scores in motion,S group is higher than SD group during T2-T5(P < 0.05),the same situation exists in comparison with the OD during each point-in-time(T1-T5),but there is no statistically significance between the SD and OD group.For Ramsay sedation score of 3 groups,group S is below the SD and OD group in the whole point-in-time(T1-T5),and S group is compared with SD and OD group,the difference has statistically significance during T1-T3(P < 0.05),there is no statistically significance between SD and OD group during T1-T5;Compared with S group,the number of SD and OD group on patient-controlled analgesia was reduced,and the number of group OD is less than the SD group,the difference is statistically significant(P < 0.05).The incidence of adverse reactions,the incidence of headache,dizziness,and itchy skin in each group has no statistical difference,but in term of the incidence of nausea,the incidence of S group is higher than other two groups,and compared with S group,the incidence of OD group has statistically significance(P < 0.05).For the incidence of postoperative delirium within three days,S is higher than SD and OD group.For the patients’ satisfaction,OD group is higher than S and SD group.Conclusion:Combining use of oxycodone and dexmedetomidine can play a good role in patient-controlled analgesia after laparoscopic colon radical surgery.Not only can provide good sedative and analgesic action,but it also reduces the dosage of opioid.Whenever,it can reduce the incidence of nausea and postoperative delirium,otherwise,it can obtain pretty satisfaction.