麻醉安全与质控2025，Vol.7Issue(4)：310-315,6.DOI:10.3969/j.issn.2096-2681.2025.04.008
术前注射盐酸羟考酮在宫颈癌根治术中超前镇痛的应用观察
Application of preoperative injection of oxymorphone hydrochloride for preemptive analgesia in patients undergoing radical surgery for cervical cancer
摘要
Abstract
Objective To explore the application effect of preoperative injection of oxymorphone hydrochloride for preemptive analgesia in patients undergoing laparoscopic radical surgery for cervical cancer.Methods Sixty five cervical cancer patients who were scheduled to undergo laparoscopic radical surgery at Luohe Central Hospital from November 2022 to November 2024 were randomly divided into the control group(group C,n=33)and the oxymorphone group(group O,n=32)according to random number table method.The two groups had the same anesthesia induction,anesthesia maintenance,and postoperative analgesia regimen.Group O received intravenous in-jection of 0.1 mg/kg oxymorphone hydrochloride 15 min before anesthesia induction,while group C received the same dose of sodium chloride solution.Hemodynamics[mean arterial pressure(MAP),heart rate(HR)at the time of entering the operating room(T0),in-tubation(T1),20 min after pneumoperitoneum(T2),extubation(T3),immediately after operation(T4)],analgesic effect[visual ana-logue scale(VAS)evaluation at the time of extubation(T5),24 h after operation(T6),48 h after operation(T7)],oxidative stress in-dex(serum cortisol,norepinephrine levels before operation and 1 2 h after operation),immune function and inflammation index[interleu-kin-6(IL-6),tumor necrosis factor-α(TNF-α),CD4+,CD8+at 15 min before operation,24 h after operation,48 h after operation]were compared between the two groups.Adverse reactions were counted.Results Compared to the T0 time point,both groups showed a decrease in HR and MAP at T1 and T2,and a rebound at T3(P＜0.05).HR and MAP at T1,T2 and T3 were higher than those of group C(P＜0.05).The VAS scores of the surgical area in group O at T5 and T6 were lower than those of group C(P＜0.05).The levels of serum cortisol and norepinephrine in both groups increased compared to preoperative levels,but the levels of serum Cor and NE of group O was lower than those of group C,at 12 h after surgery(P＜0.05).At 24 h and 48 h after surgery,the levels of serum IL-6,TNF-α,and CD8+in both groups increased compared to 15 min before surgery,while CD4+decreased.Compared with group C,the levels of IL-6,TNF-α,and CD8+in group O were lower and CD4+levels were higher at 24 h after surgery(P＜0.05).There was no statistical significant difference in the incidence of adverse reactions between groups(P＞0.05).Conclusion Preoperative injection of oxymor-phone hydrochloride for preemptive analgesia of cervical cancer can maintain stable perioperative hemodynamics,ensure analgesic effect,alleviate stress state,reduce inflammatory response,regulate immune function,and has good safety.关键词
宫颈癌/腹腔镜下宫颈癌根治术/盐酸羟考酮/镇痛/血流动力学/应激Key words
cervical cancer/laparoscopic radical surgery for cervical cancer/oxymorphone hydrochloride/analgesia/hemodynamics/stress引用本文复制引用
李永强,吴悠,郑贯峥,白娜,李宪营..术前注射盐酸羟考酮在宫颈癌根治术中超前镇痛的应用观察[J].麻醉安全与质控,2025,7(4):310-315,6.基金项目
恩泽疼痛管理医学研究项目(ezmr2022-077) （ezmr2022-077）
