布托啡诺和芬太尼用于冠脉搭桥术后镇痛的比较

目的比较布托啡诺与芬太尼用于冠脉搭桥术后静脉镇痛的疗效及不良反应。方法40例行心脏非体外循环冠脉搭桥术的病人,术后随机分入B组和F组,分别接受布托啡诺和芬太尼的病人自控静脉镇痛(PCIA)治疗。比较两组患者拔管后各时段桡动脉平均动脉压(MAP)、SPO2、疼痛程度的视觉模拟评分(VAS)、Ramesay镇静评分,以及按压镇痛泵的次数和不良反应发生率等指标。结果两组各时段的MAP、SPO2、VAS评分差异均无统计学意义(P0.05);B组的镇静评分显著低于F组(P0.05);而按压镇痛泵的次数和不良反应的发生率明显低于F组(P0.01)。结论布托啡诺用于心脏冠脉搭桥术后静脉镇痛可取得满意的镇痛效果,不良反应较少,安全可靠,优于芬太尼静脉镇痛。

Objective To compare the efficacy and safety of butorphanol versus fentanyl for patients controlled analgesia （PCIA） after operation of off-pump coronary artery bypass. Methods 40 patients undergoing the operation of off-pump coronary artery bypass were randomly divided into group B（butorphanol for PCIA, 4μg·kg-1·h-1, loading dose： 2μg·kg-1·h-1, n=20） or group F（fentanyl for PCIA, 0.3μg·kg-1·h-1, loading dose： 1μg·kg-1·h-1, n=20）, The indexes of MAP, SPO2 visual analogue scale（VAS）, Ramesay score at a series of time points after extutation, The account of pressing and the adverse reaction rate were compared between the two groups. Results No statistical difference at VAS, MAP, and SPO2 was found between the two groups. Bwo the mean Ramesay sedative score in group B was much lower than that in group F. Patients of butorphanol group had pressed the pump less and suffered fewer incidences of adverse events than those of fentanyl group. Conclusions PCIA with butorphanol could provide satisfactory analgesia and sedation for the patients after operation of off-pump coronary artery bypass. It is superior for lower incidence of adverse reactions, compared with fentanyl.