比较布托啡诺、芬太尼及芬太尼联合曲马多用于老年患者术后镇痛的临床效果

Efficiency of postoperative analgesia with butorphanol in elder patients

目的研究布托啡诺用于老年患者术后静脉镇痛的疗效及不良反应。方法60例择期行上腹部手术的老年患者,随机均分为布托啡诺组(B组)、芬太尼组(F组)及芬太尼联合曲马多组(FT组),分别接受持续静脉镇痛。记录并比较术后48h内疼痛视觉模拟评分(VAS)、Ramsay镇静评分及不良反应。结果三组术后镇痛效果VAS组内比较差异无统计学意义。但术后6hF组和B组的VAS明显低于FT组(P<0.05);术后12h,B组的VAS仍低于FT组(P<0.05)。B组术后0.5、6、12h Ramsay镇静评分明显高于F组(P<0.05)。B组恶心呕吐发生率明显低于FT组(P<0.05)。结论布托啡诺可用于老年患者术后静脉镇痛。

Objective To study the efficiency and side effects of postoperative analgesia with butorphanol in elder patients. Methods Sixty eider patients undergoing selective upper abdominal operations, were randomly assigned into 3 groups with 20 cases each. For postoperative intravenous analgesia,butorphanol 0. 125 mg/kg was given in group B, fentariyl 0. 016 mg/kg in group F and fentanyl 0. 008 mg/kg combined with Tramadol 6.25 mg/kg in group FT. The visual analogue scale （VAS） analgesic score, Ramesy sedative score and side effects were recorded and compaered among three groups within 48 h after the operations. Results There were no significant differences in VAS scores among 3 groups. VAS scores of group F and group B were much lower than those of group FT at 6 h after operation （P〈0.05）. VAS score of group B was still lower than that of group FT at 12 h after operations （P〈0. 05）. Ramesy score of group Bwas significantlyhigher than that of group Fat 0.5,6 and 12 h after operation （P〈0.05）. The incidence of postoperalion nausea and vomiting （PONV） of group B was significurtly lower than that of group FT （P〈0.05）, Conclusion Postoperative intravenous analgesia with hutorphanol can he used effectively and safeltysafe in elder patients undergoing upper abdominal operations.