目的 评价羟考酮用于非体外循环冠状动脉旁路移植术（off-pump coronary artery bypass grafting, OPCABG）后静脉镇痛的效果。 方法 择期行OPCABG的患者50例，采用随机数字表法分为2组（每组25例）：羟考酮组（Q组）和舒芬太尼组（S组）。术毕接患者自控静脉镇痛（patient-controlled intravenous analgesia， PCIA）泵至术后48 h，维持VAS<4分。Q组采用羟考酮100 mg、托烷司琼12 mg，用0.9%氯化钠注射液稀释至200 ml，背景剂量1 ml/h，单次剂量4 ml，锁定时间5 min；S组采用舒芬太尼200 μg、托烷司琼12 mg，用0.9%氯化钠注射液稀释至200 ml，背景剂量2 ml/h，单次剂量4 ml，锁定时间10 min。分别记录术后24、48 h时患者静态及动态VAS评分、镇静评分、自控镇痛有效按压次数及剂量、补救镇痛药使用率及副作用发生率，评价术后48 h时患者整体镇痛满意度。 结果 术后48 h时Q组动态镇痛良好率（89%）高于S组（25%）（P<0.05）；两组各时点静态镇痛良好率、镇静满意率、自控镇痛有效按压次数及剂量、副作用发生率、补救镇痛药使用率，以及整体镇痛满意度比较，差异均无统计学意义（P>0.05）。 结论 羟考酮PCIA可为OPCABG患者提供满意的术后镇痛效果。
Ｏｂｊｅｃｔｉｖｅ To evaluate the efficacy of oxycodone for intravenous analgesia after off-pump coronary artery bypass grafting(OPCABG). Methods Fifty patients scheduled for OPCABG were randomly divided into 2 groups (25 patients in each): received treatment with oxycodone (group Q) and sufentanil (group S). The patient-controlled intravenous analgesia (PCIA) with oxycodone or sufentanil was used for postoperative analgesia lasting for 48 h to maintain VAS<4. In group Q and S, PCIA was respectively achieved by infusing 100 mg oxycodone and 200 μg sufentanil with 12 mg tropisetron in 200 ml 0.9% sodium chloride solution. The PCIA pump was used to deliver a constant dosage of oxycodone at a rate of 0.5 mg/h with boluses of 2 mg oxycodone every 5 min in group Q, while to deliver sufentanil at a rate of 4 μg/h with boluses of 2 μg sufentanil every 10 min in group S. Pain VAS score at rest and during movement, sedation score, number of successful bolus and delivered dose, requirement for rescuing analgesic, and the adverse effects were assessed at 24 h and 48 h after administration. The levels of patient's satisfaction were recorded within 48 h after operation. Results The ratio of adequate pain relief during movement 48 h after administration in group Q(89%) was higher than in group S (25%)(P<0.05). There was no significant difference between the two groups in the ratio of adequate pain relief at rest, the ratio of desired sedation, the number of successful bolus and delivered dose, requirement for rescuing analgesic, incidence of adverse effects in different time points and levels of patient's satisfaction (P>0.05). Conclusions PCIA with oxycodone can produce satisfactory analgesic efficacy after OPCABG.
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