关键词: 羟考酮, 皮下注射, 主动脉夹层, 术前用药, 序贯法, 半数有效剂量

Abstract:

AIM: To determine the half effective dose (ED50) of oxycodone subcutaneously for preoperative analgesia in patients with Stanford type A aortic dissection using sequential method. METHODS: Thirty patients with Stanford type A aortic dissection were enrolled. The American Society of Anesthesiologists (ASA) grades II to III were scheduled for emergency surgery under general anesthesia. According to the sequential method of increasing or decreasing administration, the first patient was injected subcutaneously with oxycodone 5.0 mg 60 minutes before anesthesia, and the adjacent dose gradient was 0.5 mg. If the previous patient had satisfactory analgesic effect, the next patient dose was reduced by 0.5 mg. If the last patient's analgesic effect is not satisfactory, the next patient dose is increased by 0.5 mg. After sequential administration, visual analgesia (VAS) was used to evaluate the analgesic effect. VAS≤3 was effective in analgesia. The ED50 and 95% confidence intervals for preoperative analgesia in patients with Stanford type A aortic dissection were calculated using the Dixon and Massey sequential distribution test formula. RESULTS:The overall satisfaction of patients in satisfactory analgesic effect group was higher than that of patients in unsatisfactory analgesic effect group (P<0.05), but there was no significant difference between in the rate of remedy analgesia the two groups (P>0.05). The ED50 of subcutaneous oxycodone for preoperative analgesia in patients with Stanford type A aortic dissection was 2.9 mg with a 95% confidence interval of 2.3 to 3.4 mg. CONCLUSION:The ED50 of subcutaneous oxycodone for sequential analgesia in patients with Stanford type A aortic dissection was 2.9 mg, and the method was simple, efficient and accurate.

Key words: oxycodone, subcutaneous injection, aortic dissection, preoperative medication, sequential method, half effective dose