布托啡诺复合芬太尼用于剖宫产术后静脉镇痛

Combined buprenorphine with fentanil for patient-control intravenous analgesia after cesarean section

目的研究比较布托啡诺复合芬太尼用于术后静脉自控镇痛的效果。方法选择期剖宫产手术患者60例,美国麻醉医师协会ASAⅠ级,年龄24～30岁,随机分成3组。对照组:F组(芬太尼1.0mg+昂丹司琼8mg)和B组(布托啡诺10mg+昂丹司琼8mg);实验组:BF组(布托啡诺5mg+芬太尼0.5mg+昂丹司琼8mg)。各组均以生理盐水稀释到100mL注入PCA泵,镇痛泵参数设定均以2mL/h的速度持续静脉泵入,单次量0.5mL,锁定时间为15分钟。分别于术后4小时、8小时、12小时、24小时和36小时进行生命体征监测、视觉模拟评分(VAS)、Ram say镇静评分和观察不良反应。结果 BF组多个时间点的VAS评分低于F组和B组(P<0.05或P<0.01);BF组多个时间点的镇静评分高于F组和B组(P<0.05或P<0.01)。BF组不良反应发生率低于F组(P<0.05)。结论布托啡诺与芬太尼在镇痛镇静上有很好的协同作用,两药复合用于术后患者静脉自控镇痛效果确切,维持时间长,呼吸、循环系统平稳,副作用少。

Objective To study and compared the effects of patient-control intravenous analgesia（PCIA） combined butorphanol with fentanil after cesarean section.Methods Sixty case of cesarean section patients were selected,ASA gradesⅠ,aged 24～30 yr,were randomly divided into three groups.Contrast group： group F（n=20,Fentanil 1.0 mg ＋ ondanstron 8 mg ＋ NS=100 mL） and group B（n=20,butorphanol 10 mg ＋ ondanstron 8 mg ＋ NS=100 mL）;Experimental group ：group B（n=20,butorphanol 5 mg ＋ fentanil 0.5 mg ＋ ondanstron 8 mg ＋ NS=100 mL）.Each mixed liquid was injected to PCIA pump.All patient were received 2 mL per hour and incremental dose of 0.5 mL per 15 minutes.respiratory system and circulatory system were monitored.Pain score（VAS,Visual Analogue Scale）,sedation score（Ramsay） and side reactions were recorded at 4 h,8 h,12 h,24 h,36 h after operation.Results Some VAS were lower,some sedation score were higher and side reactions were more decreasing in group BF as compared to those of group F and group B.（P〈0.05 orP〈0.01）.Conclusion The effects of PCIA combined butorphanol with fentanil were satisfactory after operation.Analgesia time was longer.The respiratory system and the circulatory system were stable.adverse effects were fewer.