多沙普仑减轻布托啡诺术后静脉镇痛期间嗜睡的效果

Doxapram attenuates somnolence induced by postoperative intravenous analgesia with butorphanol

目的 观察不同剂量的多沙普仑对布托啡诺术后静脉镇痛期间嗜睡和镇痛效果的影响.方法 全组均为硬膜外麻醉后.随机分为单纯0.01%布托啡诺镇痛组（简称组Ⅰ,n=30）,0.01%布托啡诺和0.1%多沙普仑镇痛组（简称组Ⅱ,n=30）,0.01%布托啡诺和0.2%多沙普仑镇痛组（简称组Ⅲ,n=30）.比较各组术后镇痛效果和副作用.结果 3组均获得了满意的术后镇痛效果.镇静评分（术后8～24 h）：组Ⅰ〉组Ⅱ和组Ⅲ（分别P〈0.05）.SpO2（负荷剂量后0～30 min）：组Ⅰ分别〈组Ⅱ和组Ⅲ.三组术后8～24 h内VAS评分均≤3,差异无统计学意义.其他副作用差异无统计学意义.结论 不同剂量多沙普仑和布托啡诺合用能有效地减轻布托啡诺术后静脉镇痛期间嗜睡的副作用,0.2%多沙普仑和0.01%布托啡诺合用效果更佳.

Objective To study the effects of different dosage doxapram for attenuating somnolence induced by postoperative intravenous analgesia with butorphanol. Methods Ninety adult patients were randomly divided into three groups after epidural anesthesia. Butorphanol 0.01% （group Ⅰ ,n= 30）, butorphanol 0.01 % and doxapram 0. 1%（group Ⅱ , n = 30）, and hutorphanol 0. 01% and doxapram 0. 2% （group Ⅲ ,n=30） were given with analgesia-pump respectively. Lethargy and analgesia effect were observed and compared. Results The analgesia effects were satisfactory in all of the three groups after operation. Conscious-sedation score （at 8-24 h after operation）in group Ⅰ was higher than those in group Ⅱ and Ⅲ （P〈0. 01） respectively. SpO2 （at 0-30 min after loading dose） in group Ⅲ was lower than those in group Ⅰ and Ⅱ （P〈0. 01）. VAS （at 8-24 h after operation） was not significant differences in all three groups（P〈0.05） ,VAS was lower than 3 in all the three groups. The other side effects in the three groups were not significant differences. Conclusion Different dosage doxapram combined with butorphanol is effective for lessening lethargy symptom after using butorphanol analgesia, the effect of 0.01 % hutorphanol with 0. 2 % doxapram is better in clinic.