不同剂量布托啡诺在开胸术后患者静脉自控镇痛的比较研究

Comparative Study on Different Dosages of Butorphanol for Postoperative PCIA in Patient with Thoracic Surgery

目的比较不同剂量布托啡诺在开胸术后患者静脉自控镇痛(PCIA)的效果和安全性。方法将90例接受择期开胸手术的患者随机均分为B1组、B2组、B3组,分别使用布托啡诺8mg、10mg、12mg进行PCIA,记录术前、术后1、4、8、12、24h各时点的呼吸频率、心率、血压、血氧饱和度以及VAS、Ramsay、BCS评分和并发症发生率。结果与B1、B2组术后1、4h比较,B3组的呼吸频率和血氧饱和度有不同程度的降低(P<0.05),但仍在安全的范围内。三组患者在各时点均能获得满意的镇痛效果,其中VAS评分B3<B2<B1(P<0.05)。B3组患者术后1、4、8h的Ramsay评分明显高于B1、B2组(P<0.05)。各时点BCS评分B3>B2>B1(P<0.05)。B3组恶心、呕吐、头晕的发生率均高于B1、B2组(P<0.05)。结论三种不同剂量的布托啡诺用于开胸术后PCIA均可获得满意的镇痛效果,但10mg/100mL的配方更安全,舒适度更高。

Objective To compare the effect and safety of different dosages of butorphanol for patient-controlled intravenous analge- sia （PCIA） for thoracic surgery. Methods 90 patients scheduled for elective thoracic surgery were randomly divided into group B1 （butor- phanol 8 mg）, group B2 （butorphanol 10 mg）, group B3 （butorphanol 12 mg） for PCIA. The respiratory rate （RR）, heart rate （HR）, blood pressure （BP）, SpO2 and VAS, Ramsay, BCS score and adverse reaction before and after the operation were recorded. Results Compared with group B1 and B2, the RR, SpO2 of group B3 at postoperative 1, 4 h had decreased in different degree （P〈0.05）, but still in the safe range. Satisfactory analgesia were achieved in all of 3 groups, VAS score B3 〈 B2 〈 B1 （P〈0.05）. The Ramsay score of group B3 at postop- erative 1, 4, 8 h were significantly higher than group B1 and B2. BCS score： B3 〉 B2 〉 B1 （P〈0.05）. The incidence ofnansea and vomiting, dizziness in group B3 were significantly higher than group B1 and B2 （P〈0.05）. Conclusions Satisfactory analgesia can be achieved in 3 different dosages ofbutorphanol for PCIA in patients with thoracic surgery, but the formula of 10 mg/100 mL is more safe and comfortable.