布托啡诺复合芬太尼用于烧伤整形患者术后自控镇痛的临床效果

CLINICAL APPLICATION OF BUTORPHANOL COMBINED FENTANYL ON PATIENT CONTROLLED ANALGESIA IN PATIENTS UNDERGOING POSTBURN PLASTIC SURGERY

目的观察布托啡诺复合芬太尼对烧伤整形患者术后自控镇痛临床效果。方法择期拟行烧伤整形手术患者66例,ASAⅠ或Ⅱ级,随机分为3组(n=22),术后接电子镇痛泵分别用芬太尼(A组),布托啡诺(B组)以及布托啡诺复合芬太尼(C组)行自控静脉镇痛(PCA)。记录三组患者拔除气管导管即刻及镇痛后1、8、24 h患者VAS疼痛评分、镇静评分及呼吸抑制、皮肤瘙痒、恶心呕吐、尿潴留等发生率。结果 B组在镇痛后1、8、24 h VAS评分和SS镇静评分均高于A组(p<0.05),而C组与A组比较无统计学差异;A组的呼吸抑制、皮肤瘙痒、恶心呕吐的发生率高于B组和C组(p<0.05),B组和C组比较无统计学差异。结论布托啡诺复合芬太尼用于烧伤患者术后镇痛效果较单纯使用芬太尼或布托啡诺效果好。

Objective To observe Clinical effect of Butorphanol combined fentanyl on self controlled analge sia in patients undergoing post burn plastic surgery. Methods 66 patients with ASA I II grade undergoing post burn plastic surgery, were randomly divided into three groups（22 in each group） ： fentanyl （A group）, Butorphanol group （B group） and butorphanol ＋ fentanyl group （C group）, After operation,all the patients received electro anal gesia pump undergoing patient controlled analgesia （PCA） with fentanyl, Butorphanol, and butorphanol ＋ fentanyl respectively. The visual analog scales （VAS）, SS sedation scale, and incidence rate of respiratory depression, itch ofskin, nausea and vomiting were recorded at extubation, 1, 8, and 24 h after patient controlled analgesia （PCA）. Results At l, 8 and 24 h after patient controlled analgesia （PCA） post operation, the patients in group B showed significantly higher VAS scores and SS sedation scale compared with the patients in group A and group C （p 〈0. 05）, and there was no significant difference between group A and group C. Group A has higher Incidence rate of respiratory depression, itch of skin, nausea and vomiting compared with the patients in group B and group C （p 〈0. 05）, and there was no significant difference between group B and group C. Conclusion Clinical application of Butorphanol combined fentanyl on patient controlled analgesia in patients undergoing post burn plastic surgery is better than single use of Butorphanol or fentanyl respectively.