布托啡诺和芬太尼用于妇科术后患者自控静脉镇痛

Postoperative patient-controlled intravenous analgesia with butorphanol and fentanyl in patients underwent hysterectomy

目的观察布托啡诺复合芬太尼用于妇科术后患者自控静脉镇痛(PCIA)的疗效及不良反应。方法60例行子宫切除术患者均分为A、B、C三组,分别接受布托啡诺加芬太尼(A组)、布托啡诺(B组)或芬太尼(C组)PCIA治疗。采用视觉模拟评分(VAS)评估PCIA4、8、12、24、48h的疼痛评分、血压(BP)、心率(HR)、脉搏血氧饱和度(SpO2)以及不良反应发生情况。结果三组镇痛效果均较满意,A组4、8、12h的VAS评分虽均低于其他两组(P<0.05),但都<2.0分,镇痛效果优良。镇痛期间各时点的BP、SpO2、HR、RR都在正常范围。C组恶心、呕吐发性率明显高于A组(P<0.01),B组头晕的发生率略高于其他两组,A组的不良反应发生率相对较低。结论与芬太尼比较,布托啡诺PCIA镇痛效果满意,两药合用效果更好,不良反应较少。

Objective To observe the efficacy and side effects of butorphanol and fentanyl for postoperative patient-controlled intravenous analgesia （PCIA） . Methods Sixty patients underwent hysterectomy were randomly divided into 3 groups with 20 cases each. Butorphanol 5 mg combined with fentanyl 0.5 mg was used in group A, butorphanol 10 mg in group B or fentanyl 1.0 mg in group C was used alone. The drug of each case was added into normal saline 100 ml. PCIA was set 2 ml/h for background infusion and PCA dose was 0.5 ml with a lock time of 15 min. VAS scores,BP, HR,SpO2 and adverse effects were recorded at 4,8,12,24 and 48 h after operation. Results Analgesia was all satistactory in three groups. VAS scores were higher in group B than those in groups of A and C at 4, 8 and 12 h （P〈0. 05）,which were still less than 2. BP, HR,SpO2 were all in the normal limits. The incidence of nausea and vomiting was higher in group C than that in the other groups （P〈0.01）. Conclusion Compared with fentanyl,PCIA with butorphanol may provide a satisfactory postoperative analgesia witt/less adverse effects.