Effects of perioperative oxycodone as the sole opioid on immunity within a multi-modal analgesia framework in patients undergoing cervical cancer surgery: A randomised controlled trial.

IF 2.9 Q1 ANESTHESIOLOGY
Indian Journal of Anaesthesia Pub Date : 2025-02-01 Epub Date: 2025-01-29 DOI:10.4103/ija.ija_736_24
Jingjing Liu, Sumeng Chen, Jianxiao Chen, Hailian Liu, Weiyi Li, Haomin Chi, Xiaowei Ding, Shaoqiang Huang
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Abstract

Background and aims: Current views on oxycodone's effects on immunity are inconsistent. Our objective was to compare the effects of perioperative oxycodone as the sole opioid in a multi-modal analgesia regimen with conventional opioid regimens on immunity in cervical cancer.

Methods: In this randomised controlled trial (RCT), patients scheduled for laparoscopic radical hysterectomy for cervical cancer were randomised to receive either oxycodone (Group O) or conventional opioid regimens (Group C). The primary outcome was the CD4+/CD8+ ratios postoperatively at 24 and 48 h. Student's t-test was used for normally distributed variables, the non-parametric Wilcoxon test for non-normally distributed variables, and Chi-square/Fisher's exact test for qualitative variables, with differences significant set at P < 0.05.

Results: We included 56 patients in the final analysis. The postoperative CD4+/CD8+ ratios were comparable between groups. However, the mean arterial pressures (MAPs) at extubation and 5 minutes thereafter were lower in Group O than in Group C (both P < 0.001), as were the heart rates (HRs) (P = 0.001 and 0.018, respectively). Within 24 h postoperatively, the visual analogue scale (VAS) scores for resting and movement-evoked pain were lower in Group O than in Group C (all P < 0.001), and the same was observed at 48 h postoperatively (both P = 0.002), as was the incidence of catheter-related bladder discomfort (P = 0.001). The VASs for postoperative analgesia satisfaction were higher in Group O than in Group C (P = 0.006).

Conclusion: In laparoscopic surgery for cervical cancer, perioperative oxycodone as the sole opioid within a multi-modal analgesia framework does not yield anticipated benefits in immunopreservation compared to conventional opioid regimens but improves postoperative pain management and haemodynamic stability.

围手术期羟考酮作为唯一阿片类药物对宫颈癌手术患者多模式镇痛框架下免疫的影响:一项随机对照试验
背景与目的:目前对羟考酮免疫作用的看法并不一致。我们的目的是比较围手术期羟考酮作为多模式镇痛方案中唯一的阿片类药物与传统阿片类药物方案对宫颈癌患者免疫的影响。方法:在这项随机对照试验(RCT)中,计划进行腹腔镜宫颈癌根治性子宫切除术的患者被随机分配接受羟考酮(O组)或常规阿片类药物治疗(C组)。主要结局是术后24和48小时的CD4+/CD8+比率。正态分布变量使用学生t检验,非正态分布变量使用非参数Wilcoxon检验,定性变量使用卡方/Fisher精确检验。P < 0.05,差异有统计学意义。结果:我们将56例患者纳入最终分析。两组术后CD4+/CD8+比值具有可比性。然而,拔管时和拔管后5分钟,O组的平均动脉压(map)低于C组(P < 0.001),心率(hr)也低于C组(P分别= 0.001和0.018)。术后24 h内,O组静息疼痛和运动疼痛的视觉模拟评分(VAS)均低于C组(均P < 0.001),术后48 h观察到的结果相同(均P = 0.002),导管相关性膀胱不适的发生率也低于C组(P = 0.001)。O组术后镇痛满意度vas高于C组(P = 0.006)。结论:在宫颈癌腹腔镜手术中,与传统阿片类药物方案相比,围手术期羟可酮作为多模式镇痛框架中唯一的阿片类药物在免疫保存方面没有预期的益处,但可以改善术后疼痛管理和血流动力学稳定性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.20
自引率
44.80%
发文量
210
审稿时长
36 weeks
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