布托啡诺与舒芬太尼联合用于食管肿瘤切除术后患者自控静脉镇痛的效果

Efficiency of patient-controlled intravenous analgesia with butorphanol and sufentanil following resection of esophageal carcinoma

目的研究布托啡诺与舒芬太尼联合应用于食管肿瘤切除术后患者自控静脉镇痛（patient-controlledintravenous analgesia,PCIA）的临床效果及其安全性。方法60例ASAⅠ-Ⅲ级的食管肿瘤患者,随机均分为3组行PCIA。B组：布托啡诺0.15 mg/kg;S组：舒芬太尼2μg/kg;BS组（布托啡诺0.075 mg/kg＋舒芬太尼1μg/kg）。监测并记录术后4、12、24、48 h患者的镇痛（VAS评分）和镇静（Ramsay评分）效果及副作用发生情况。结果3组镇痛效果均确切可靠。B组VAS评分显著高于S组和BS组（P〈0.05）;S组和BS组之间差异无显著性（P〉0.05）。B组患者Ramsay评分显著高于S组和BS组（P〈0.05）;S组和BS组之间差异无显著性（P〉0.05）。BS组不良反应发生例数显著低于其余两组（P〈0.05）。结论布托啡诺与舒芬太尼联合应用于食管肿瘤术后PCIA,镇痛效果确切可靠而不良反应少,是一种理想的镇痛方式。

Objective To evaluate the efficacy and safety of butorphanol and sufentanil in patient-controlled intravenous analgesia（PCIA） subsequent to esophageal carcinoma resection.Methods 60 ASA Ⅰ to Ⅲ patients undergoing elective resection for esophageal carcinoma were randomized into 3 groups,who received PCIA with 0.15 mg/kg butorphanol（group B）,2 μg/kg sufentanil（group S） and 0.075 mg/kg butorphanol with 1 μg/kg sufentanil（group BS）,respectively.The efficacy and side effects were evaluated by VAS scores and Ramsay scores at 4,12,24,48 hours after operation.Results All the patients showed good relief with PCIA,but VAS scores of group B was significantly higher than those of groups S and BS（P〈0.05）.There were no significant differences in VAS scores between group S and group BS（P〉0.05）.The Ramsay scores of group B were significantly higher than those of group S and group BS（P〈0.05）.There were no significant differences in Ramsay scores between group S and group BS（P〉0.05）.The prevalence of side effects in group BS was significantly lower than that in other groups.Conclusion Butorphanol combined with sufentanyl in PCIA exhibits good effect of analgesia and minor adverse reactions;which enables a safer and more effective method of analgesia.