布托啡诺、咪达唑仑和氟芬合剂对阑尾切除术中牵拉反应的抑制作用

Butorphanol,midazolam and innovar in relieving traction response during appendectomy

目的比较阑尾切除手术过程中运用布托啡诺、咪达唑仑和氟芬合剂对阑尾牵拉反应的抑制效果。方法连续硬膜外麻醉下行阑尾切除手术的患者68例,随机分为布托啡诺组(n=21)、咪达唑仑组(n=23)和氟芬合剂组(n=24)。三组均在切皮时静脉给药,观察并记录各组阑尾牵拉反应、镇静评分、心率(HR)、平均动脉压(MAP)和脉搏血氧饱和度(SpO2)变化,并进行组间比较分析。结果与术前比较,三组患者手术中HR、MAP和SpO2等生命体征指标无明显变化。布托啡诺、咪达唑仑和氟芬合剂组抑制阑尾牵拉反应的有效率分别为95.2%、65.2%和50.0%。统计学分析表明,布托啡诺组的镇静评分和抑制阑尾牵拉反应的有效性明显优于其他两组(P<0.05或P<0.01)。结论阑尾切除术中运用布托啡诺可以明显减轻手术中牵拉反应。

Objective To compare the effects of butorphanol, midazolam and innovar on relieving appendix traction response during appendectomy. Methods Sixty-eight patients who underwent appendectomy were randomly divided into butorphanol group （ n = 21 ） , midazolam group （ n = 23 ） and innovar group （ n = 24 ）. Butorphanol, midazolam and innovar were intravenously administered to patients during skin incision. The appendix traction response, sedation score, heart rate （HR）, mean arterial pressure （MAP） and pulse oxygen saturation （SpO2 ） were recorded and compared among groups. Results Compared with those before operation, there was no significant changes in HR, MAP and SpO2 during operation. The effective rates of butorphanol, midazolam and innovar in relieving appendix traction response were 95.2% , 65.2% and 50.0% , respectively. Butorphanol surpassed midazolam and innovar in sedation and relieving appendix traction response （P 〈0.05 or P 〈0.01 ）. Conclusion Appendix traction response during appendectomy can be significantly relieved by butorphanol.