布托啡诺与氟芬合剂用于妇科椎管内麻醉的疗效对比研究

Comparative research on butorphanol or innovar treatment for gynecological patients undergoing laparotomy by spinal anesthesia

目的对比观察布托啡诺和氟芬合剂用于妇科椎管内麻醉的镇静、镇痛效果及副作用。方法选择椎管内麻醉,需行开腹手术的妇科患者40例,ASA评分Ⅰ～Ⅱ级,随机分成2组,每组20例。切皮前静脉给药,A组给予布托啡诺0.015 mg/kg,B组给予氟芬合剂1/2。分别记录BIS、BP、P、SpO2变化,镇静评分,牵拉反应及术后恶心呕吐情况,并进行组间比较。结果给药后,两组BIS值均明显降低,达到镇静状态。且在各时间段,布托啡诺组的BIS值低于氟芬合剂组,镇静评分高于氟芬合剂组。两组交感兴奋性减弱,心率、血压均降低,且基本变化平稳。两组血氧基本无明显降低。两组患者均有牵拉反射出现,但均出现在二次或多次开腹手术患者。布托啡诺组出现1例恶心呕吐患者。结论布托啡诺妇科椎管内麻醉镇静镇痛效果优于氟芬合剂,且副作用较少。

Objective To evaluate analgesic and sedative effect and side effects of butorphanol or innovar on gynecological patients undergoing laparotomy by spinal anesthesia.Methods In a randomized,double-blind study,40 gynecological patients,belonging to ASA Grades Ⅰ and Ⅱ undergoing laparotomy by spinal anesthesia,were allocated into 2 groups（20 patients in each group）.Patients were injected butorphanol 0.015 mg/kg（Group A）and innovar 1/2（Group B）intravenously before skin incision.Changes of BIS,vital parameters,sedative scores,traction reaction,and PONV were recorded and compared.Results After injection,the BIS decreased significantly in each group.In group A,BIS was lower,while Ramsay score was higher,compared with those of group B in each time period.As a result of weaken of sympathetic activity,BP and P in each group decreased,but in a safe scale.No significant difference was found in SpO2 between the 2 groups.There were patients occurred traction reactions in 2 groups,but appeared mostly in patients with secondary or repeatedly surgery.There was a patient occurred PONV in group A.Conclusion Butorphanol has better effects in analgesia and sedation on gynecological patients undergoing laparotomy by spinal anesthesia with less side effects,compared with innovar.