Application Research Of Oxycodone Analgesia After Thoracic Surgery In The Elderly

Part one:Comparison of oxycodone and sufentanil analgesia in elderly patients after thoracicObjective The aim of this study was to assess the efficacy and safety of Oxycodone for postoperative analgesia in elderly after thoracotomy.Methods Sixty aged 65-75 yr,both sexes,with BMI of 18-25kg/m2,ASAⅠ/Ⅱ,scheduled for elective thoracotomy,were randomly divided into either oxycodone group and sufentanil group using a random number.The 2 group received total intravenous ansthesia.PCIA solution contained oxycodone 50 mg in 100 ml NS,without background infusion,Bolus 4ml,lockout interval 5min in group Q.PCIA solution contained sufentanil 150μg in 100 ml NS,basal infusion 2ml/h,Bolus 0.5ml,lockout interval 5min in group S.The VAS of both rest and cough,level of patient’s satisfaction with analgesia,and analgesia-related adverse events were recorded.Results The incidence of nausea and vomiting was significantly lower in group O than group S(p<0.05).There was no significant difference in the VAS score at both rest and cough,level of patient’s satisfaction,the requirement for rescue analgesic,and incidence of dizziness and over-sedation between the two groups(p>0.05).No patients developed respiratory depression and pruritus in the two groups.Conclusion Oxycodone for postoperative analgesia in elderly after thoracotomy was safe and effective;oxycodone can produce similar analgesic compared with sufentanil,with lower incidence of nausea and vomiting.Part two: Clinical observation of oxycodone in elderly patients with thoracoscopic resection of lung cancer after analgesiaObjective To compare with the efficacy of Oxycodone versus sufentanil for postoperative analgesia in elderly after VATS using intercostal nerve blockade.Methods Sixty aged 65-75 yr,both sexes,with BMI of 18-25kg/m2,ASAⅠ/Ⅱ,scheduled for elective VATS,were randomly divided into either oxycodone group and sufentanil group using a random number.Both group use intercostal nerve block with bupivacaine 0.25% applied at the end of the operation by surgeons.PCIA solution contained oxycodone 50 mg in 100 ml NS,without background infusion,Bolus 4ml,lockout interval 5min in group Q.PCIA solution contained sufentanil 150μg in 100 ml NS,basal infusion 2ml/h,Bolus 0.5ml,lockout interval 5min in group S.The VAS of both rest and cough,level of patient’s satisfaction with analgesia,and analgesia-related adverse events were recorded.Results The VAS score at both rest and cough and the incidence of nausea and vomiting was significantly lower in group O than group S(p<0.05),level of patient’s satisfaction was higher in group O than group S(p<0.05).There was no significant difference in the requirement for rescue analgesic,and incidence of dizziness and over-sedation between the two groups(p>0.05).No patients developed respiratory depression and pruritus in the two groups.Conclusion Compare to sufentanil,oxycodone has better effect against visceral pain and with lower incidence of nausea and vomiting to the elderly after VATS using intercostal nerve block.Part three:Clinical observation of oxycodone combined with intercostal nerve block analgesia after thoracic surgery in the elderlyObjective The aim of the study was to observe the Oxycodone with intercostal nerve blockade for postoperative analgesia in elderly thoracotomy.Methods Sixty aged 65-75 yr,both sexes,with BMI of 18-25kg/m2,ASAⅠ/Ⅱ,scheduled for elective thoracotomy,were randomly divided into either oxycodone group and sufentanil group using a random number.Before closure of the chest,Q group use intercostal nerve block with namal saline by surgeons,Q+IB group use intercostal nerve block with bupivacaine 0.25% by surgeons.PCIA solution contained oxycodone 50 mg in 100 ml NS,without background infusion,Bolus 4ml,lockout interval 5min was the same in group.The VAS of both rest and cough,level of patient,s satisfaction with analgesia,and analgesia-related adverse events were recorded.Results The VAS score at both rest and cough and dosage of oxycodone was significantly lower in group O+IB than group O(p<0.05),level of patient’s satisfaction was significantly higher in group O+IB than group S(p<0.05).There is no significant difference in the requirement for rescue analgesic,and incidence of dizziness and over-sedation between the two groups(p>0.05).No patients developed respiratory depression and pruritus in the two groups.Conclusion Oxycodone with intercostal nerve blockade has better pain relief,less analgesics dosage,and better patient’s satisfaction.