The Median Effective Dose(ED50) Of Intravenous Oxycodone Combined With Different Induction Doses Sufentanil For Postoperative Analgesia Following Thoracic Surgical Procedures In Elderly

Objective:The sequential method estimated the median effective dose of a single intravenous oxycodone injection to inhibit acute pain after thoracoscopic surgery in elderly patients induced by different doses of sufentanil.Meanwhile,the effects of oxycodone intravenous injection on mean blood pressure,heart rate and the occurrence of related adverse reactions were analyzed to provide reference for the use of oxycodone during perioperative period.Methods : The study included patients undergoing elective thoracoscopic lung resection under general anesthesia from June 2022 to October 2022.The experiment was divided into two groups at the same time,low induction dose sufentanil group(Sufentanil 0.5μg/kg,S2 Group),high induction dose sufentanil group(Sufentanil0.5μg/kg,S2 Group).The dose of intravenous oxycodone for the first patient in both groups was 0.05mg/kg about 20 minutes before the end of the operation,and local infiltration with ropivacaine was given when the chest was closed.The Dixon sequential method were applied to calculate the ED50 of intravenous oxycodone.Repeated measures analysis of variance was used for hemodynamic comparison,and postoperative follow-up indicators were expressed in cases,and statistical analysis was performed using chi-square test or Fisher test.Results:In total,50 patients(21 patients in the S1 group and 29 patients in the S2group)were enrolled.The ED50 and 95%CI of S1 Group and S2 Group were0.045mg/kg(0.044-0.047mg/kg)and 0.027mg/kg(0.026-0.029mg/kg),respectively.Administration of oxycodone 20 minutes before the end of operation did not cause changes in mean arterial pressure and heart rate within 5 minutes,but mean arterial pressure at 30 minutes after extubation was lower than that of basal mean arterial pressure and at 3 minutes after extubation,heart rate had no significant difference.Conclusion:The ED50 and 95%CI that with a single injection of oxycodone in the0.3μg/kg sufentanil-induction group were 0.045mg/kg(0.044-0.047mg/kg)for thoracoscopic lobectomy in the elderly,and 0.027mg/kg(0.026-0.029mg/kg)of the0.5μg/kg sufentanil-induction group.A single intravenous injection of oxycodone does not reduce blood pressure and heart rate for a short time.Compared with the high-induction dose sufentanil group,the low-induction dose sufentanil group had better postoperative pain score and comfort score within 24 hours after surgery,and the total opioid dosage within 24 hours after surgery was less.