布托啡诺加入局麻药用于臂丛神经阻滞的效果观察

Clinical Observation on Effect of Butorphanol Used with Local Anesthetic for Brachial Plexus Block

目的：观察布托啡诺加入局麻药用于臂丛神经阻滞的效果、术后镇痛作用方面的影响。方法：ASAⅠ～Ⅱ级在臂丛神经阻滞下手术患者，随机分为两组，每组20例，局麻药为0．25％速卡和1％利多卡因混合液25mL，A组布托啡诺1mg与局麻药混和用于臂丛神经阻滞；B组不用布托啡诺。记录术中（麻醉后1h），术后4、8、12、24、36、48h各时间点的疼痛评分，疼痛程度采用“视觉模拟评分”（VAS）评定，评估术后镇痛持续时间（术毕到术后VAS〉3分的时间），并注意各种不良反应。结果：术中、术后各时间点A组VAS明显低于B组（P〈0．01），A组镇痛持续时间长，与B组相比有极显著性差异（P＜0．01）。结论：臂丛神经阻滞时加用布托啡诺能明显增强臂丛阻滞效果和术后镇痛作用，延长术后镇痛时间，不良反应发生率低。

Objective： To observe the postoperative analgesia produced hy the addition of hutorphanol to local anesthetic in hrachial plexus block. Methods： Forty ASA Ⅰ-Ⅱ patients scheduled for upper extremity surgery under brachi al plexus block were randomly allocated into two groups. Group A received 25mL of the mixture solution of 0. 25% lebutorphanol and 1% lignocaine plus butorphanol 1 mg for hrachial plexus block, group B used the same local anesthetic alone. The visual analogue scale （VAS） and side effects were evaluated at lh after local anesthetic infusion and 4,8,12.24.36.48h after operation. The analgesia was considered satisfactory if the score was 3 or less or if the patient was asleep. Results： The VAS was significantly lower and the median duration of satisfactory analgesia lasted significantly longer in group A than those in group B（P〈0. 01）. Conclusion：The addition hutorphanol to local anesthetic in brachial plexus block enhances and prolongs the analgesia.