丁丙诺啡静脉自控镇痛在脊柱外科术后的应用

Application of Self-controlled Intravenous Analgesia with Buprenorphine after Spine Operations

目的观察丁丙诺啡静脉病人自控镇痛（PICA）在脊柱内固定术后镇痛的疗效.方法 60例因脊柱疾患而需行内固定的患者随机分为吗啡组（M组）、曲马多组（T组）、丁丙诺啡组（B组）,每组20例.B组泵盒中加入丁丙诺啡1.5 mg,欧必停2.5 mg.各组都用生理盐水稀释至100 mL.镇痛方法采用负荷剂量＋持续输注＋病人自控模式,设置负荷量5 mL;持续剂量为2 mL/h;锁定时间为15 min;PCA剂量为0.5 mL.观察镇痛效果和不良反应.结果 3组患者术后镇痛效果评估M组、T组与B组相比无显著差异;M组的不良反应发生率为50%,T组的不良反应发生率为40%,B组的不良反应发生率为20%,3组比较B组与另外两组有显著性差异（P〈0.05）,3组患者只有T组有1例患者发生呼吸抑制.结论丁丙诺啡PICA用于脊柱内固定术后的镇痛,疗效满意,不良反应较少.

Objective Observing the effect of self-controlled intravenous analgesia with Buprenorphine after internal fixation of spine operations. Methods Sixty patients suffering spine disease were randomly divided into morphine group（group M）, tramadol group（group T）, buprenorphine group（group B）, each group had twenty patients. Buprenorphine 1.5 mg, Navoban 2.5 g in group B pump box, then add 0.9% saline to 100 mL. Analgesia infusion model was loading dose ＋ background dose ＋ self-controlled. Results There was not different analgesia effect among three groups, but group B had less side effect than other two groups. Conclusion It is safe and effective to use Buprenorphine to ease pain after internal fixation of spine operations.