Title:Analgesic Efficacy and Safety of Spinal Oxycodone in Total Hip
Arthroplasty: A Preliminary Study
Volume: 29
Issue: 21
关键词:
不良反应，麻醉，镇痛，鸦片类，羟考酮，疼痛，治疗。
摘要:
Aim: The aim of this study was to assess the analgesic efficacy and safety of 1
mg and 0.5 mg oxycodone administration in a spinal block procedure for a total hip
arthroplasty (THA).
Patients and Methods: Forty-two THA patients aged 59-81 with American Society Anesthesiology
(ASA) II-III were included. All patients received anesthesia using spinal
blockade, with bupivacaine 0.5% spinal heavy 2.5 ml, with 0.5 ml oxycodone hydrochloride
1.0 mg (group A; n = 28) or 0.5 mg (group B; n = 14). During surgery, each patient
was sedated with 2-4 mg/kg/h intravenous propofol infusion. They received 100 mg intravenous
ketoprofen at the end of the surgery at 8 pm and 8 am, with recommended doses
every 12 h thereafter. Subcutaneous morphine 5 mg was used as a rescue analgesic, and
the time to morphine use was recorded. After surgery, pain intensity (at the moment of
patient report) was assessed using an 11-point numerical rating scale (NRS). The incidence
of adverse effects was monitored. Blood samples were taken for assays of serum
oxycodone, noroxycodone and bupivacaine levels.
Results: The time to rescue analgesia was 9.6 ± 5.6 h in group A and 7.3 ± 1.9 h in group
B, and it did not differ between patient groups (P = 0.179). The mean NRS pain score
was 4.5 in group A and 4.2 in group B. Three group A patients had detectable oxycodone
levels: two < 7.1 ng/ml and in 1 spinal block induced anesthesia was unsuccessful and so
he/she underwent general anesthesia (this patient was excluded from the analysis). Four
group B patients had single values < 5 ng/ml. Noroxycodone levels were in all patients
undetectable, and bupivacaine levels were 70-300 ng/ml. Regarding adverse effects, one
patient had hypotension, one had bradycardia, and one had pruritus.
Conclusion: Oxycodone in spinal block prolongs analgesia period, does not cause serious
adverse effects and seems to be safe and effective opioid for patients undergoing
THA.
