布托啡诺术后硬膜外自控镇痛的剂量探讨

Effects of different dose of butorphanol in patient controlled epidural analgesia

目的采用硬膜外自控镇痛(PCEA)技术,对不同剂量布托啡诺术后镇痛效应进行研究。方法90例ASAⅠ级或Ⅱ级的下腹部或下肢手术病例,随机分成3组,Ⅰ组用0.004%布托啡诺,Ⅱ组用0.006%布托啡诺,Ⅲ组用0.008%布托啡诺,3组均混入0.125%布比卡因,采取双盲对比观察镇痛效果和不良反应。结果术后48h3组病人的VAS评分,Ⅰ组高于Ⅱ组和Ⅲ组(P<0.05),Ⅱ组与Ⅲ组相当(P>0.05)。Ramsay评分Ⅲ组高于Ⅱ组和Ⅰ组(P<0.05)。尿潴留、头晕发生率Ⅲ组高于Ⅱ组和Ⅰ组(P<0.05),Ⅱ组和Ⅰ组相当(P>0.05)。结论选择布托啡诺PCEA以0.006%剂量(浓度)为佳。

[Objective] To investigate the effects of different doses of butorphanol in patient controlled epidural analgesia （PCEA）. [Methods] 90 patients ASA physical statusⅠ - Ⅱ which were scheduled lower abdominal or lower-extremity surgery were divided into three groups randomly. The 0.004% butorphanol group （group Ⅰ ）, the 0.006% butorphanol group （group Ⅱ ） and the 0.008% butorphanol group （group Ⅲ）. Three groups were all mixed with 0.125% bupivacaine. The analgesia effect and the side effect were compared double-blindly. [Results] The VAS of group I was higher than groupⅡ and group Ⅲ （P 〈0.05） and there＇s no statistics differences between group Ⅰand group Ⅱ （P 〉0.05） in 48 h after the operation. The Ramsay of group Ⅲ was higher than group I and group Ⅱ （P 〈0.05）. The incidence of urine retention and dizziness of group Ⅲ was higher than group Ⅰand group Ⅱ （P 〈 0.05） and no statistics differences between group Ⅰ and group Ⅱ （P 〉0.05）. [Conclusion] 0.006% butorphanol was the most effective dose with less side effects.