PDF(Pubmed)
Abstract：
UNASSIGNED: Oxycodone is a potent μ- and κ-opioid receptor agonist that can relieve both somatic and visceral pain. We assessed oxycodone- vs sufentanil-based multimodal analgesia on postoperative pain following major laparoscopic gastrointestinal surgery.
UNASSIGNED: In this randomised double-blind controlled trial, 40 adult patients were randomised (1:1, stratified by type of surgery) to receive oxycodone- or sufentanil-based multimodal analgesia, comprising bilateral transverse abdominis plane blocks, intraoperative dexmedetomidine infusion, flurbiprofen axetil, and oxycodone- or sufentanil-based patient-controlled analgesia. The co-primary outcomes were time-weighted average (TWA) of visceral pain (defined as intra-abdominal deep and dull pain) at rest and on coughing during 0-24 h postoperatively, assessed using the numerical rating scale (0-10) with a minimal clinically important difference of 1.
UNASSIGNED: All patients completed the study (median age, 64 years; 65% male) and had adequate postoperative pain control. The mean (SD) 24-h TWA of visceral pain at rest was 1.40 (0.77) in the oxycodone group vs 2.00 (0.98) in the sufentanil group (mean difference=-0.60, 95% CI, -1.16 to -0.03; P=0.039). Patients in the oxycodone group had a significantly lower 24-h TWA of visceral pain on coughing (2.00 [0.83] vs 2.98 [1.26]; mean difference=-0.98, 95% CI, -1.66 to -0.30; P=0.006). In the subgroup analyses, the treatment effect of oxycodone vs sufentanil on the co-primary outcomes did not differ in terms of age (18-65 years or >65 years), sex (female or male), or type of surgery (colorectal or gastric). Secondary outcomes (24-h TWA of incisional and shoulder pain, postoperative analgesic usage, rescue analgesia, adverse events, and patient satisfaction) were comparable between groups.
UNASSIGNED: For patients undergoing major laparoscopic gastrointestinal surgery, oxycodone-based multimodal analgesia reduced postoperative visceral pain in a statistically significant but not clinically important manner.
UNASSIGNED: Chinese Clinical Trial Registry (ChiCTR2100052085).
UNASSIGNED: In this randomised double-blind controlled trial, 40 adult patients were randomised (1:1, stratified by type of surgery) to receive oxycodone- or sufentanil-based multimodal analgesia, comprising bilateral transverse abdominis plane blocks, intraoperative dexmedetomidine infusion, flurbiprofen axetil, and oxycodone- or sufentanil-based patient-controlled analgesia. The co-primary outcomes were time-weighted average (TWA) of visceral pain (defined as intra-abdominal deep and dull pain) at rest and on coughing during 0-24 h postoperatively, assessed using the numerical rating scale (0-10) with a minimal clinically important difference of 1.
UNASSIGNED: All patients completed the study (median age, 64 years; 65% male) and had adequate postoperative pain control. The mean (SD) 24-h TWA of visceral pain at rest was 1.40 (0.77) in the oxycodone group vs 2.00 (0.98) in the sufentanil group (mean difference=-0.60, 95% CI, -1.16 to -0.03; P=0.039). Patients in the oxycodone group had a significantly lower 24-h TWA of visceral pain on coughing (2.00 [0.83] vs 2.98 [1.26]; mean difference=-0.98, 95% CI, -1.66 to -0.30; P=0.006). In the subgroup analyses, the treatment effect of oxycodone vs sufentanil on the co-primary outcomes did not differ in terms of age (18-65 years or >65 years), sex (female or male), or type of surgery (colorectal or gastric). Secondary outcomes (24-h TWA of incisional and shoulder pain, postoperative analgesic usage, rescue analgesia, adverse events, and patient satisfaction) were comparable between groups.
UNASSIGNED: For patients undergoing major laparoscopic gastrointestinal surgery, oxycodone-based multimodal analgesia reduced postoperative visceral pain in a statistically significant but not clinically important manner.
UNASSIGNED: Chinese Clinical Trial Registry (ChiCTR2100052085).
摘要：
■羟考酮是一种有效的μ-和κ-阿片受体激动剂，可以缓解躯体和内脏疼痛。我们评估了基于羟考酮和舒芬太尼的多模式镇痛对腹腔镜胃肠大手术后疼痛的影响。
■在这项随机双盲对照试验中，40例成人患者随机(1:1,按手术类型分层)接受基于羟考酮或舒芬太尼的多模式镇痛,包括双侧横腹平面阻滞，术中输注右美托咪定，氟比洛芬酯，和羟考酮或舒芬太尼为基础的患者自控镇痛。共同主要结局是术后0-24小时休息和咳嗽时内脏疼痛（定义为腹内深痛和钝痛）的时间加权平均值（TWA），使用数字评定量表（0-10）进行评估，最小的临床重要差异为1。
■所有患者均完成研究（中位年龄，64岁；65%为男性），术后疼痛得到了充分控制。羟考酮组内脏痛24小时平均TWA为1.40（0.77），舒芬太尼组为2.00（0.98）（平均差异=-0.60，95％CI，-1.16至-0.03；P=0.039）。羟考酮组患者咳嗽时内脏疼痛的24小时TWA显著降低(2.00[0.83]vs2.98[1.26];平均差=-0.98,95%CI,-1.66至-0.30;P=0.006)。在亚组分析中，羟考酮与舒芬太尼对共同主要结局的治疗效果在年龄(18-65岁或>65岁)方面没有差异,性别（女性或男性），或手术类型（结直肠或胃）。次要结果（切口和肩痛的24小时TWA，术后镇痛药的使用，抢救镇痛,不良事件,和患者满意度）组间具有可比性。
■对于接受腹腔镜胃肠大手术的患者，以羟考酮为基础的多模式镇痛可显著降低术后内脏痛,但在临床上无重要意义.
■中国临床试验注册中心(ChiCTR2100052085)。
■在这项随机双盲对照试验中，40例成人患者随机(1:1,按手术类型分层)接受基于羟考酮或舒芬太尼的多模式镇痛,包括双侧横腹平面阻滞，术中输注右美托咪定，氟比洛芬酯，和羟考酮或舒芬太尼为基础的患者自控镇痛。共同主要结局是术后0-24小时休息和咳嗽时内脏疼痛（定义为腹内深痛和钝痛）的时间加权平均值（TWA），使用数字评定量表（0-10）进行评估，最小的临床重要差异为1。
■所有患者均完成研究（中位年龄，64岁；65%为男性），术后疼痛得到了充分控制。羟考酮组内脏痛24小时平均TWA为1.40（0.77），舒芬太尼组为2.00（0.98）（平均差异=-0.60，95％CI，-1.16至-0.03；P=0.039）。羟考酮组患者咳嗽时内脏疼痛的24小时TWA显著降低(2.00[0.83]vs2.98[1.26];平均差=-0.98,95%CI,-1.66至-0.30;P=0.006)。在亚组分析中，羟考酮与舒芬太尼对共同主要结局的治疗效果在年龄(18-65岁或>65岁)方面没有差异,性别（女性或男性），或手术类型（结直肠或胃）。次要结果（切口和肩痛的24小时TWA，术后镇痛药的使用，抢救镇痛,不良事件,和患者满意度）组间具有可比性。
■对于接受腹腔镜胃肠大手术的患者，以羟考酮为基础的多模式镇痛可显著降低术后内脏痛,但在临床上无重要意义.
■中国临床试验注册中心(ChiCTR2100052085)。
