不同剂量国产布托啡诺术后静脉镇痛效果比较

Clinical comparison on postoperative intravenous anesthetic effects and adverse reactions of domestic butorphanol at different dosages

目的评价不同剂量国产布托啡诺用于术后静脉持续自控镇痛(PCIA)疗效及药物不良反应发生率。方法ASAⅠ～Ⅱ级剖腹手术与骨科手术患者174例,划分为三组,分别给予布托啡诺0.15mg/kg(Ⅰ组)、0.20mg/kg(Ⅱ组)和0.25mg/kg(Ⅲ组)用于术后PCIA治疗,镇痛持续时间至术后48h。结果镇痛效果Ⅲ组>Ⅱ组>Ⅰ组(P<0.01),而不良反应发生人数Ⅰ、Ⅱ组间无明显差异(P>0.05),Ⅲ组患者不良反应发生人数则明显多于Ⅰ、Ⅱ组(P<0.05),>60岁患者不良反应发生率要显著高于同组青中年患者(P<0.01)。结论布托啡诺镇痛效果与用药剂量成正相关,不良反应发生率与用药剂量及患者年龄相关,建议术后PCIA用药剂量宜从小剂量(0.15mg/kg)开始。

Objective To evaluate the post-operative anesthetic effects and the incidence rates of adverse reactions of butorphanol at different dosages in patient undergoing PCIA. Methods The 174 patients which had underwent open abdominal surgery and orthopaedic surgery were randomly divided in to three groups. Group Ⅰ was administered with butorphanol 0.15mg/kg,group Ⅱ 0.2mg/kg,group Ⅲ 0.25mg/kg. Results There were significantly differences in anesthetic effects among three groups （P〈 0.01）,ie group Ⅲ〉group Ⅱ 〉group Ⅰ （P〈0.01）. There were not differences in incidence rates of adverse reactions between group Ⅰ and group Ⅱ （P〉0.05）,but group Ⅲ were significantly higher than group Ⅰ and group Ⅱ （P〈0.05）,the patients over 60yr old were higher than other patients in same group（P〈0.01）. Conclusion The anesthetic effects of butorphanol is positively correlated to pharmic dosage,but the incidence rates of adverse reactions is correlated to the age and pharmic dosang, thus authors suggest that after operation pharmic dosage of PCIA should be started from low dosage（0.15mg/kg）.