布托啡诺术后静脉镇痛对血浆5-羟色胺、P物质和肾上腺素的影响

Effects of PCIA with butorphanol on 5-HT,P substance and epinephrine

目的观察布托啡诺用于术后静脉自控镇痛对血清致痛物质5-羟色胺（5-HT）、P物质（PS）和肾上腺素（E）的影响。方法全麻手术患者30例随机均分为布托啡诺组（B组）、吗啡组（M组）和对照组（D组）。B组布托啡诺浓度0.006%,给药速率为0.0024 mg·kg^-1·min^-1,负荷剂量为0.005 mg/kg,每次有效按压给药0.003 mg/kg,锁定间隔时间10 min。M组吗啡浓度为0.025%,给药速率为0.005 mg·kg^-1·min^-1,负荷剂量为0.05 mg/kg,每次有效按压给药0.03 mg/kg,锁定间隔时间10 min。D组在患者需求时给予肌注吗啡10 mg。分别于麻醉诱导前（T0）、术后12 h（T1）、24 h（T2）、36 h（T3）、48 h（T4）采集肘静脉血3 ml,采用酶联免疫吸附测定法测定血清中5-HT、PS和E水平。结果B、M组T1-T4时5-HT、PS和E水平均低于D组（P〈0.05）。结论布托啡诺静脉自控镇痛能抑制术后血清致痛物质5-HT、PS和E水平的升高,在一定程度上减弱痛觉信息传递,减轻机体应激反应。

Objective To study the effects of patient-controlled intravenous analgesia（PCIA） with butorphanol on plasma 5-Hydroxytryptamine（5-HT）,P substance（PS）,and epinephrine（E）.Methods Thirty surgical patients were randomly divided into three groups with 10 cases each.PCIA with butorphanol was given in group B,with morphine in group D.The patients in group D were given morphine injection intramuscular when when needed.Venous blood samples were taken before anesthesia（T0）,at 12 h（T1）,24 h（T2）,36 h（T3）,and 48 h（T4）during analgesia for detecting plasma 5-HT,PS and E by ELISA.Results Compared to group D,plasma levels of 5-HT,PS and E were significantly lower in groups of B and M at T1 to T4（P〈0.05）.Conclusion PCIA with butorphanol may attenuate the stress response to pain by suppressing the increase of 5-HT and PS and E in plasma.