布托菲诺用于老年患者腹部手术后自控镇痛的观察

Butorphanol combined with 0. 15%bupivacaine for postoperative patient-controlled epidural analgesia after elderly abdominal surgery

目的 观察布托啡诺复合0.15%布比卡因用于老年患者腹部手术后硬膜外镇痛（PCEA）的效果及副作用.方法 全麻联合硬膜外麻醉下行胃肠道肿瘤根治术的老年患者45例.随机分为3组各15例,术后予以PCEA,A组配制为：吗啡60 μg/ml;B组为：布托啡诺60μg/ml;C组为：布托啡诺80μg/ml,三组均含0.15%布比卡因.术后观察各个时间点的镇痛效果、PCA按压次数、生命体征变化,以及小良反应.结果 三组术后各时间点的VAS评分均小于3,各组之间无统计学差异（P〉0.05）,PCA按压次数亦无统计学差异（P〉0.05）,生命体征没有明显变化.A组的术后不良反应明显多于B组与C组（P〈0.05）,而C组眩晕者明显多于A组和C组（P〈0.05）.结论 老年人腹部手术后PCEA使用布托啡诺60 μg/ml复合低浓度布比卡因,效果可靠且不良反应少.

Objective To evaluate the clinical effects and adverse reactions of butorphanol used in the patient-controlled epidural analgesia （PCEA） postoperatively after elderly abdominal surgery. Methods Forty-five patients undergoing selective abdominal tumor surgery under combined epidural and general anesthesia were assigned to three groups received patient-controllea epidural analgesia （PCEA） postoperatively, group A with morphine 60μg/ml（n= 15）, group B butorphanol 60μg/ml （n=15）, and group C butorphanol 80μg/ml （n=15） and 0.15% bupivacaine in every groups. Visual analogue scale（VAS） , PCA press times, vital signs and adverse reactiorm were monitored. Results There were no significantly differences of VAS, PCA press times and vital signs between the three groups （P〈0.05）. The incidence of emesis and pruritus in group A were higher than those in group B and C（P〈0.05）. The dizziness in group C was higher than that in group A and B（P〈0.05）. Conclusion When used in postoperative PCEA, butorphanol can provide as satisfied effect as morphine does, however, the adverse reactions of butorphanol were tess than those of morphine for elderly patients after abdominal surgery.