Objective  To observe the effect of oxycodone hydrochloride combined with parecoxib sodium preemptive analgesia on postoperative pain in patients undergoing gynecologic laparoscopic surgery.

Methods  The clinical data of patients who underwent gynecological laparoscopic surgery at the General Hospital of Huainan Oriental Hospital Group from July 2021 to February 2023 were retrospectively analyzed and the patients were divided into a control group (parecoxib sodium) and a combined group (oxycodone hydrochloride combined with parecoxib sodium) according to the different preemptive analgesic regimens. The observational indexes of this study included opioid consumption within 24 h postoperatively, visual analog scale (VAS) scores at 0, 2, 6, 12 and 24 h postoperatively, the number of effective presses of the patient controlled analgesiac (PCA), the time of the first press of the PCA, the number of remedial analgesia, the satisfaction of analgesia, and the occurrence of postoperative adverse reactions.

Results  A total of 80 patients were included in the study, with 39 in the control group and 41 in the combined group. The time of the first press of the analgesic pump was significantly longer in the combined group than in the control group (P<0.05), while the number of effective presses and sufentanil consumption were significantly lower in the combined group than in the control group (P<0.05). The difference in the number of remedial analgesia between the two groups was not statistically significant (P>0.05). The VAS scores at 0 h, 2 h and 6 h postoperatively in the combined group were significantly lower than those in the control group (P<0.05), and the differences between the VAS scores at 12 h and 24 h postoperatively were not statistically significant (P>0.05). The analgesic satisfaction score of patients in the combined group was significantly higher than that of the control group (P<0.05), and the difference in the incidence of adverse reactions was not statistically significant (P>0.05).

Conclusion   The preemptive analgesia regimen of oxycodone hydrochloride combined with parecoxib sodium significantly reduced the consumption of opioid drugs in patients after gynecological laparoscopic surgery, alleviated postoperative pain, and improved patient satisfaction.

1.林艺, 杜文文, 王均炉. 喉罩通气方式对妇科腹腔镜手术患者的影响[J]. 数理医药学杂志, 2023, 36(8): 609-613. [Lin Y, Du WW, Wang JL. The influence of laryngeal mask ventilation methods on patients undergoing gynecological laparoscopic surgery[J]. Journal of Mathematical Medicine, 2023, 36(8): 609-613.] DOI: 10.12173/j.issn.1004-4337.202304130.

2.Park JH, Lee C, Shin Y, et al. Comparison of oxycodone and fentanyl for postoperative patient-controlled analgesia after laparoscopic gynecological surgery[J]. Korean J Anesthesiol, 2015, 68(2): 153-158. DOI: 10.4097/kjae.2015.68.2.153.

3.Glare P, Aubrey KR, Myles PS. Transition from acute to chronic pain after surgery[J]. Lancet, 2019, 393(10180): 1537-1546. DOI: 10.1016/s0140-6736(19)30352-6.

4.Kwon YS, Kim JB, Jung HJ, et al. Treatment for postoperative wound pain in gynecologic laparoscopic surgery: topical lidocaine patches[J]. J Laparoendosc Adv Surg Tech A, 2012, 22(7): 668-673. DOI: 10.1089/lap.2011.0440.

5.Sluka KA, Wager TD, Sutherland SP, et al. Predicting chronic postsurgical pain: current evidence and a novel program to develop predictive biomarker signatures[J]. Pain, 2023, 164(9): 1912-1926. DOI: 10.1097/j.pain. 0000000000002938.

6.肖锐. 不同气腹压力联合不同神经肌肉阻滞深度对老年RARP患者术后肾功能的影响[D]. 长沙: 中南大学, 2022. DOI: 10.27661/d.cnki.gzhnu.2022.001232.

7.Azevedo I, Figueroa PU. Commentary: can preemptive analgesia decrease opioid use after foregut laparoscopic surgery?[J]. Mosby, 2020, 159(2): 747-748. DOI: 10.1016/j.jtcvs.2019.06.072.

8.Kelly DJ, Ahmad M, Brull SJ. Preemptive analgesia I: physiological pathways and pharmacological modalities[J]. Canadian J Anesth, 2001, 48(10): 1000-1010. DOI: 10.1007/BF03016591.

9.Puthoff TD, Veneziano G, Kulaylat AN, et al. Development of a structured regional analgesia program for postoperative pain management[J]. Pediatrics, 2021, 147(3): e20200138. DOI: 10.1542/peds.2020-0138.

10.俄尔曲布, 余得水, 孙广运, 等. 超前股神经-坐骨神经阻滞对胫腓骨骨折手术患者术后短期认知功能及镇痛的影响[J]. 西部医学, 2023, 35(2): 266-271. [E'er QB, Yu  DS, Sun GY, et al. The influence of advanced femoral nerve-sciatic nerve block on short-term postoperative cognitive function and analgesia in patients undergoing tibiofibular fracture surgery[J]. Western Medicine, 2023, 35(2): 266-271.] DOI: 10.3969/j.issn. 1672-3511.2023.02.022.

11.刘洋, 王生, 韩庆波. 帕瑞昔布超前镇痛对腹腔镜子宫肌瘤剥除术患者应激因子及不良反应的影响[J]. 重庆医学, 2020, 49(13): 2111-2114. [Liu Y, Wang S, Han QB. The influence of parecoxib preemptive analgesia on stress factors and adverse reactions in patients undergoing laparoscopic myomectomy[J]. Chongqing Medicine, 2020, 49(13): 2111-2114.] DOI: 10.3969/j.issn.1671-8348.2020.13.011.

12.王凤捷, 蔡宁, 代晨旭, 等. 帕瑞昔布钠超前镇痛联合右美托咪定喷喉对腹腔镜子宫肌瘤剔除术患者应激反应及镇痛效果的影响[J]. 中国性科学, 2021, 30(10): 64-67. [Wang FJ, Cai N, Dai CX, et al. The influence of parecoxib sodium preemptive analgesia combined with dexmedetomidine spray on the stress response and analgesic effect of patients undergoing laparoscopic hysteromyomectomy[J]. Chinese Journal of Human Sexuality, 2021, 30(10): 64-67.] DOI: 10.3969/j.issn.1672-1993. 2021.10.019.

13.Chen C, Zhang Z, Lin M, et al. Acupressure versus parecoxib sodium in acute renal colic: a prospective cohort study[J]. Front Med (Lausanne), 2022, 9: 968433. DOI: 10.3389/fmed.2022.968433.

14.Chen X, Chen P, Chen X, et al. Efficacy and safety of parecoxib and flurbiprofen axetil for perioperative analgesia in children: a network meta-analysis[J]. Front Med (Lausanne), 2023, 10: 1231570. DOI: 10.3389/fmed.2023.1231570.

15.Ge Z, Li M, Chen Y, et al. The efficacy and safety of parecoxib multimodal preemptive analgesia in artificial joint replacement: a systematic review and meta-analysis of randomized controlled trials[J]. Pain Ther, 2023, 12(4): 1065-1078. DOI: 10.1007/s40122-023-00500-6.

16.蒋维香, 邱燕, 魏小珍, 等. 盐酸羟考酮联合丙泊酚用于无痛纤支镜麻醉的效果[J]. 西部医学, 2022, 34(12): 1812-1816. [Jiang WX, Qiu Y, Wei XZ, et al. The effect of oxycodone hydrochloride combined with propofol for painless fiberoptic bronchoscopy anesthesia[J]. Medical Journal of West China, 2022, 34(12): 1812-1816.] DOI: 10.3969/j.issn.1672-3511.2022.12.018.

17.Umukoro NN, Aruldhas BW, Rossos R, et al. Pharmacogenomics of oxycodone: a narrative literature review[J]. Pharmacogenomics, 2021, 22(5): 275-290. DOI: 10.2217/pgs-2020-0143.

18.乐婷, 杨勇, 肖娈, 等. 羟考酮超前镇痛方案有效性与安全性的系统评价与Meta分析[J]. 中国急救复苏与灾害医学杂志, 2024, 19(6): 801-806. [Le T, Yang Y, Xiao  L, et al. Systematic evaluation and Meta-analysis of the effectiveness and safety of oxycodone preemptive analgesia regimens[J]. China Journal of Emergency Resuscitation and Disaster Medicine, 2024, 19(6): 801-806.] DOI: 10.3969/j.issn.1673-6966.2024.06.024.

19.张旭梅, 罗窅, 袁琴, 等. 腕踝针联合耳穴贴压对子宫腺肌病术后镇痛的影响[J]. 上海针灸杂志, 2023, 42(6): 639-643. [Zhang XM, Luo Y, Yuan Q, et al. Effect of wrist and ankle needles combined with auricular acupoint pressing on postoperative analgesia for adenomyosis[J]. Shanghai Journal of Acupuncture and Moxibustion, 2023, 42 (6): 639-643.] DOI: 10.13460/j.issn.1005-0957.2023.06.0639.

20.Lenfant L, Canlorbe G, Belghiti J, et al. Robotic-assisted benign hysterectomy compared with laparoscopic, vaginal, and open surgery: a systematic review and meta-analysis[J]. J Robot Surg, 2023, 17(6): 2647-2662. DOI: 10.1007/s11701-023-01724-6.

21.周玉静. 帕瑞昔布钠超前镇痛对妇科腹腔镜术后疼痛的影响[J]. 海南医学院学报, 2015, 21(10): 1422-1424. [Zhou YJ. The influence of parecoxib sodium preemptive analgesia on postoperative pain after gynecological laparoscopy[J]. Journal of Hainan Medical University, 2015, 21(10): 1422-1424.] DOI: 10.13210/j.cnki.jhmu. 20150505.022.

22.李孟佳. 基于ERAS理念探讨电针对妇科微创手术的临床疗效[D]. 南京: 南京大学, 2021. DOI: 0.27253/d.cnki.gnjzu.2021.000575.

23.侯春光, 徐磊. 腹腔镜胆囊切除术后羟考酮联合帕瑞昔布钠的镇痛效果评价及对炎症应激反应的影响[J]. 海南医学院学报, 2017, 23(24): 3393-3396. [Hou CG, Xu L. Evaluation of the analgesic effect of oxycodone combined with parecoxib sodium after laparoscopic cholecystectomy and its influence on inflammatory stress response[J]. Journal of Hainan Medical University, 2017, 23(24): 3393-3396.] DOI: 10.13210/j.cnki.jhmu.20171211.002.

24.王伟娟, 刘英, 戴仁锋, 等. 羟考酮和帕瑞昔布钠对鼻内镜手术患者麻醉苏醒期躁动和术后疼痛及血清炎性因子的影响[J]. 中华全科医学, 2020, 18(3): 388-391. [Wang WJ, Liu Y, Dai RF, et al. The influence of oxycodone and parecoxib sodium on restlessness during anesthesia recovery period, postoperative pain and serum inflammatory factors in patients undergoing nasal endoscopic surgery[J]. Chinese Journal of General Practice, 2020, 18(3): 388-391.] DOI: 10.16766/j.cnki.issn.1674-4152.001254.

25.Lao WL, Song QL, Jiang ZM, et al. The effect of oxycodone on post-operative pain and inflammatory cytokine release in elderly patients undergoing laparoscopic gastrectomy[J]. Front Med (Lausanne), 2021, 8: 700025. DOI: 10.3389/fmed.2021.700025.

26.刘丝濛,岳云. 短效氯胺酮和长效帕瑞昔布钠预先镇痛效果的比较[J]. 中华医学杂志, 2018, 98(48): 3930-3935. [Liu SM, Yue Y. Comparison of the preemptive analgesic effects of short-acting ketamine and long-acting parecoxib sodium[J]. National Medical Journal of China, 2018, 98(48): 3930-3935.] DOI: 10.3760/cma.j.issn.0376-2491.2018.48.005.

27.詹慧明, 黄娟娟, 陈璟莉. 盐酸羟考酮联合帕瑞昔布钠对后腹腔镜肾癌根治术患者的影响[J].中国医药导报, 2017, 14(25): 73-76, 93. [Zhan HM, Huang JJ, Chen J. The influence of oxycodone hydrochloride combined with parecoxib sodium on patients undergoing retroperitoneal laparoscopic radical nephrectomy for renal cancer[J]. Chinese Journal of General Practice, 2017, 14(25): 73-76, 93.] https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY201725019.htm.

28.周立业, 王鹏. 羟考酮联合帕瑞昔布钠超前镇痛对腹腔镜下子宫切除术患者围术期应激反应及血清CXCL13、CXCR5影响[J]. 中国计划生育学杂志, 2022, 30(12): 2773-2777. [Zhou LY, Wang P. Effect of oxycodone plus parecoxib sodium for advanced analgesia on perioperative stress response and serum CXCL13 and CXCR 5 in patients with laparoscopic hysterectomy[J]. Chinese Journal of Family Planning, 2022, 30(12): 2773-2777.] DOI: 10.3969/j.issn.1004-8189.2022.12.022.