布托啡诺与芬太尼在靶控输注手术后静脉镇痛的临床效果比较

Comparison of the effects of butorphanol with fentanyl on postoperative analgesia in patient with targetcontrolled infusion

目的比较布托啡诺与芬太尼在靶浓度控制性输注（TCI）患者术后镇痛效果和不良反应。方法TCI患者80例，年龄19～60岁，手术范围：颈、胸、腹、脊柱、四肢，随机分为两组（n=40）：布托啡诺组（A组）和芬太尼组（B组），A组布托啡诺8～10mg加生理盐水至100ml，B组芬太尼0．8～1．0mg加生理盐水至100ml，两组负荷剂量均为曲马朵100mg，背景输注量均为2ml／h，锁定时间均为15min，术后观察BP，HR，SpO2，镇痛评分，患者满意度与副作用。结果布托啡诺组与芬太尼组镇痛效果和满意度相似，镇静评分A组〉B组；恶心，呕吐A组〈B组；嗜睡A组〉B组。结论与芬太尼相比，布托啡诺在靶浓度控制性输注术后患者亦可提供满意的镇痛，镇静效果较芬太尼明显。

Objective To compare the analgesic and side effects of butorphanol with fentanyl postoperative analgesia in the patient with target-controlled infusion（TCI） anesthesia after neck, chest, abdomen, spine and limbs operations. Methods Eighty patients, aged from 19 to 60, were devided into two groups. 40 patients in each. Butorphanol 8-10 mg in group A and fentanyl 0.8- 1mg in group B were added to normal saline 100ml. Loading dose for two groups was tramadol 100 mg, background infusion 2 ml/h, lock time 15 minutes. BP, HR, SpO2, VAS, sedation score, patient satisfaction, and side effects were observed after the surgery. Results VAS and patient satisfaction were almost the same in the two groups. Sedation score in group A was higher than that in group B. The incidence of nausea and vomiting in group A was lower than that in group B. The sleepiness rate in group A was much higher than that in group B. Conclusions Comparing with fentanyl, butorphanol has a similar analgesic effects, with stronger sedative effect.