布托啡诺或曲马多联合舒芬太尼用于脊柱手术术后镇痛的效果比较

Comparison of Effects Between Butorphanol and Tramadol Combined with Sufentanil in Postoperative Analgesia after Spinal Operation

目的：比较布托啡诺合舒芬太尼与曲马多合舒芬太尼用于脊柱术后患者自控镇痛的效果及不良反应。方法：将60例ASA I^II级的择期后路脊柱手术患者随机分为布托啡诺联合舒芬太尼组（B组）与曲马多联合舒芬太尼组（T组），记录术后4、8、12、24、48h疼痛视觉模拟评分（visual analogue pain scale，VAS）、舒适度评分（Bruggman comfort score，BCS）、Ramsay镇静评分、PCA按压次数及不良反应。结果：两组术后各时段的VAS评分和自主按压次数差异均无统计学意义（P>0.05）；B组各时段的BCS和Ramsay镇静评分均高于T组（P<0.05）；B组的不良反应发生率低于T组（P<0.05）。结论：两种方法均有良好的镇痛效果，而布托啡诺合舒芬太尼患者满意度高、不良反应较少，但其较强的镇静作用在临床中应特别注意。

Objective:To compare the effects and safety between Butorphanol and tramadol combined with sufentanil in postoperative analgesia after spinal operation. Methods:60 patients received general anesthesia during posterior spinal surgery, with ASA I to II, were randomly divided into two groups. The butorphanol combined with sufentanil or tramadol combined with sufentanil were used in group B and T respectively. The visual ana-logue scale (VAS), Brugmann comfort score (BCS), Ramsay sedative score and side effects were recorded and compared between two groups within 48 hours after the operation. Results:There was no significant difference in VAS and the times of self-compression between two groups (P>0.05). BCS and Ramsay score of group B was significantly higher than those of group T at 8, 12 and 24 hours after operation (P<0.05). The incidence of postoperative nausea and vomiting (PONV) and pruritus of group B was significantly lower than those of group T (P<0.05). Conclusion:Two groups of patients with analgesic effect are exact. The use of butorphanol combined with sufentanil has better patients’satisfaction and fewer adverse reac-tions, but its strong sedative effect should be paid special attention in clinical.