Clinical Observation Of Oxycodone Hydrochloride Used In Abdominal Surgery Under General Anesthesia With Tracheal Intubation Induced

Objective: General anesthesia often required endotracheal intubation.Stimulation caused by laryngoscopy and tracheal intubation,Hemody-namic response,which develops secondary to laryngoscopy and tracheal intubation,include heart rate,catecholamine level,blood pressure,and rate-pressure product,is very disadvantageous to the potential risk of cardiovascular patient,could cause serious complications of cerebrovascular accident and myocardial infarction improperly.Anesthesiologists have focused on controlling secondary responses to laryngoscopy and intubation.For this purpose,the anesthesiologist has taken a series of clinical measures,including improved intubation device,using the supraglottic airway tools and visualization techniques such as video laryngoscope,fiberoptic bronchoscopy;several drugs were also used,including lidocaine,opioids,sodium nitroprusside,nitroglycerine,?-2 agonists,? blockers,and calcium channel blockers.With the development of science,technology and medical,also the emergence of new drugs and technology,and continuous change of the disease spectrum and the constant updating of group of patients,medical environment and policy changes,it makes clinical work facing severe challenges.Safety is still first in the medical treatment,the high risk of anesthesia also makes the anesthesia doctors continue to take learning progress,the use of newer and safer drugs and technology,equipment,consolidate their own security line of defense.Oxycodone hydrochloride is opioid alkaloid of semi synthetic thebaine derivatives,for pure o Mu and kappa receptors agonist,rapid onset,analgesic effect,lasting effect,and the maintenance of stable hemodynamics and postoperative nausea and vomiting occurred rate less [1,2].At present oxycodone hydrochloride injection is used for cancer analgesia and postoperative analgesia [3⁵] abroad,but domestic reported less.This study intends to investigate oxycodone hydrochloride for endotracheal intubation under general anesthesia,induced clinical effect on its safety and effectiveness,and to provide the reference for clinical.Methods: From December 2014 to December 2015,60 patientsin in our hospital undergoing abdominal region surgery,male or female,aged 18-60 years,body mass index ranged from 18 to 25 kg/m2,ASA I or II,were completely randomly divided into fentanyl group?Group F?,low dose of oxycodone group?group Q₁?,high dose of oxycodone group?group Q₂?,20 cases in each group.Induction of general anesthesia with midazolam 0.05 mg/kg,propofol 1.5 mg/kg and CIS atracurium 0.15 mg/kg,group F intravenous injection of fentanyl 3 ug/kg,group Q₁ intravenous oxycodone hydrochloride 0.2 mg/kg,group Q₂ vein injection of oxycodone hydrochloride 0.3 mg/kg.Tracheal intubation was performed after anesthesia,and mechanical ventilation was performed in connection with the anesthesia machine.Systolic pressure?SBP?and diastolic blood pressure?DBP?,mean arterial pressure?MAP?,heart rate?HR?were recorded in the three groups before induction?T₀?,during intubation?T₁?,1 min after intubation?T₂?,3 min after intubation?T₃?,5 min after intubation?T₄?.Rate-pressure product were calculated and observed in the three groups.Serum cortisol?COR?,serum norepinephrine?NE?and serum epinephrine?E?are valued at the T₀,T₂ and T₄ time point.The adverse reactions and complications during anesthesia induction were recorded too.Results:1 Compared with group F,SBP,DBP,MAP,RPP and HR increased significantly in intubation?T₁?,1 min after intubation?T₂?,3min after intubation?T₃?,5 min after intubation?T₄?in group Q₁?P<0.05?.2 Serum COR,NE and E are significantly higher in group Q₁ than that in group F at the T₀,T₂ and T₄ time point?P<0.05?.3 The incidence of tachycardia was increased at the time of induction?P< 0.05?;4 It was no statistical difference in SBP,DBP,MAP,HR,RPP,anesthesia induced adverse reactions and complications at each time point,beteween group F and group Q₂?P>0.05?.Serum cortisol?COR?,serum norepinephrine?NE?and serum epinephrine?E?are similar at the T₀,T₂ and T₄ time point?P>0.05?.5 Compare Q₁ and Q₂ groups all point in SBP,DBP,MAP,HR,RPP,T₀,T₂,T₄ and serum concentration of COR,NE and e,Q₁ Q₂ Group increased significantly,with a statistically significant difference.Conclusion: For patients undergoing laparotomy,0.3 mg/kg oxycodone hydrochloride injection for induction and tracheal intubation under general anesthesia,which could effectively inhibit the cardiovascular response to tracheal intubation,maintain hemodynamics steadily and have a satisfactory clinical result.