摘要
目的通过与吗啡作对比研究酒石酸布托啡诺在术后硬膜外镇痛中的效能和副作用。方法56例择期行在腰硬联合麻醉下行下腹部手术患者，男36例，女20例，年龄21岁～63岁，ASAⅠ～Ⅱ，随机分成二组：M组（吗啡组n=28）：0．004％吗啡＋0．12％布比卡因，B组（酒石酸布托啡诺n=28）：0．004％酒石酸布托啡诺＋0．12％布比卡因，进行硬膜外术后镇痛。手术缝皮时分别向两组病人硬膜外腔注射吗啡或酒石酸布托啡诺1mg做为负荷剂量，然后接硬膜外PCA泵，参数设定如下背景输入速度2ml／h，自控镇痛剂量0．5ml／次，锁定时间15min。用VAS评分评价镇痛效果，同时观察硬膜外术后镇痛的并发症。结果两组镇痛效果都较为满意；酒石酸布托啡诺组的VAS评分低于吗啡组，但无统计学意义。酒石酸布托啡诺组瘙痒、恶心、呕吐的发生率低于吗啡组。结论酒石酸布托啡诺硬膜外术后镇痛效果可靠，副作用少，值得在临床中推广使用。
Objective To investigate the efficacy and side effects of butorphanol bartrate, compared with morphine, in postoperative epidural analgesia. Methods Fifty-lsix patients （ ASA status Ⅰ or Ⅱ ） schedule for low abdominal surgery under combined spinal - epidural anesthesia were randomly assigned to two groups： group M （0.004% morphine with 0.12% bupivacaine） and group B （ 0. 004% butorphanol with 0. 12% bupivacaine） for PCEA. All patients received epidural bolus of morphine or butophanol bartrate 1 mg followed by epidural infusion at a rate of 2 ml/h. PCA dose （ 0.5 ml ） was administered as required by the patients for supplemental analgesia with 15 min lockout. VAS was used to evaluate analgesic efficacy, and side effects such as pruritus, nausea, vomiting, somnolence, and urinary retention were also observed. Results The analgesic efficacy was sufficient in both groups, while the VAS score was lower in group B but not statistically significant compared with that in group M. However the incidence of side effects including pruritus, nausea and vomiting, and urinary retention was lower in group B than in group M. No evidence of serious respiratory depression was seen in any patient. Conclusion We can conclude that epidural analgesia with butorphanol bartrate for postoperative pain is satisfactory and safe.
出处
《国际麻醉学与复苏杂志》
CAS
2007年第2期111-112,117,共3页
International Journal of Anesthesiology and Resuscitation
关键词
疼痛
术后镇痛
硬膜外镇痛
吗啡
布托啡诺
pain
post operative analgesia
epidural analgesia
morphine
butorphanol
