布托啡诺或曲马多复合芬太尼用于全麻术后镇痛的临床效果比较

Effect Comparison on Patient-controlled Intravenous Analgesia Using Butorphanol or Tramador Combined with Fentanyl after General Anesthesia

目的比较布托啡诺复合芬太尼与曲马多复合芬太尼用于全麻术后病人自控镇痛的效果及不良反应。方法 60例择期乳腺癌根治术行全身麻醉患者,随机分为两组,每组30例:A组为布托啡诺配伍芬太尼组,B组为曲马多配伍芬太尼组。记录并比较术后4、8、16、24、48 h疼痛视觉模拟评分(visual analogue pain scale,VAS)、舒适度评分(Bruggman comfort score,BCS)及Ramsay镇静评分及不良反应。结果两组术后镇痛效果VAS评分和自主按压次数相比均无统计学差异(P>0.05);A组术后4、8、16、24 h BCS及Ramsay镇静评分明显高于B组(P<0.05),其恶心呕吐及皮肤瘙痒发生率均明显低于B组(P<0.05)。结论布托啡诺复合芬太尼镇痛效果确切,不良反应较少,是全麻术后镇痛治疗的良好选择之一。

Objective To compare the clinical effect and safety between butorphanol combined with fentanyl and tramadol with fentanyl after general anesthesia.Methods 60 patients received general anesthesia during selective radical mastectomy,with ASA Ⅰ to Ⅱ,were randomly divided into two groups with 30 cases for each.The butorphanol combined with fentanyl or tramadol combined with fentanyl were used in group A and B respectively.The visual analogue scale（VAS）,Brugmann comfort score（BCS）,Ramsay sedative score and side effects were recorded and compared between two groups within 48 hours after the operation.Results There was no significant difference in VAS and the times of self-compression between two groups（P0.05）.BCS and Ramsay score of group A was significantly higher than those of group B at 4,8,16 and 24 hours after operation（P0.05）.The incidence of postoperative nausea and vomiting（PONV） and pruritus of group A was significantly lower than those of group B（P0.05）.Conclusion The use of butorphanol combined with fentanyl has a good effect of analgesia and fewer adverse reaction in patients-controlled analgesia after general anesthesia.