摘要
目的探讨术前小剂量布托啡诺超前镇痛对妇科腹腔镜木后镇痛效果的影响。方法60例ASAⅠ～Ⅱ级妇科腹腔镜手术患者，随机分为Ⅰ组（术前10min预注布托啡诺1mg，4mg术后静脉镇痛）、Ⅱ组（手术结束前10min静注布托啡诺1mg，4mg术后静脉镇痛）、Ⅲ组（8mg术后静脉镇痛）。观察三组不同给药时机患者术后2、4、8、12、24h时VAS、BCS、Ramesy评分及不良反应的情况。结果Ⅰ、Ⅲ组各时点的VAS评分均明显低于Ⅱ组（P〈0．05）；Ⅰ、Ⅱ组术后12h、24h的Ramesy评分明显低于Ⅲ组（P〈0．05）；三组间BCS差异评分无统计学意义（P〉0．05）。术后有一定程度的恶心、呕吐、头晕、尿潴留、皮肤瘙痒发生，Ⅲ组发生率较高，均未见呼吸抑制发生。结论不同时机使用布托啡诺影响腹腔镜术后疼痛的治疗效果，术前小剂量布托啡诺明显减少术后静脉镇痛用药量，效果确切，不良反应少，值得临床推广应用。
Objective To evaluate the clinical effects of butorphanol preempitive analgesia on postoperative analgesia undergoing gynecological laparoscopic operation. Methods Sixty ASA Ⅰ - Ⅱ patients undergoing gynecological laparoscopic operation were randomly allocated to three groups with 20 cases. The patients in group Ⅰ were given 1 mg butorphanol during 10 minutes before operation and 4 mg PCI, group Ⅱ were given 1 mg butorphanol during 10 minutes before the end of surgery and 4 mg PCI, group m were given 8 mg butrphanol PCI. The analgesia effect were evaluated by VAS, BCS and Ramesy scores at 2,4,8, 12, 24 h and the side effects were reconded. Results VAS scores of groups Ⅰand Ⅲ were significantly lower than those of group Ⅱ （P 〈 0. 05）, Ramesy scores of groups Ⅰ and Ⅱ were significantly lower than those of group Ⅲ at 12 and 24 h （P 〈 0. 05） and BCS scores were no statistical difference among the groups（ P 〉 0.05 ）. The incidence of side effects including nausea and vomiting, urinary retention and pruritus was higher in group Ⅲ than in groups Ⅰ and Ⅱ , no evidence of serious respiratory depression was seen in any patient. Conclusion The using of Butorphanol effect on therapeutic efficacy of postoperative analgesia in different stage,preemptive analgesia with butorphanol decrease postoperative requirement of analgesia and is effective, covenient and safe with less side effect in the patients undergoing laparoscopy,it deserve clinical application.
出处
《临床医学》
CAS
2008年第9期12-14,共3页
Clinical Medicine
关键词
布托菲诺
超前镇痛
妇科腹腔镜
Butorphanol
Preemptive analgesia
Gynecological laparoseopy
