地佐辛复合不同剂量布托啡诺用于下肢术后静脉镇痛的研究

Study on analgesic of dezocine combined with different doses of butorphanol for postoperative patient-controlled intravenous analgesia after lower limbs surgery

目的比较地佐辛复合不同剂量布托啡诺用于下肢术后静脉镇痛的临床效果。方法择期骨科手术患者90例，美国麻醉医师协会（ASA）Ⅰ或Ⅱ级，年龄20～55岁，按随机数字表法分为A、B、C三组，每组30例，术毕按三种方案施行患者自控静脉镇痛（PCIA）。每组用地佐辛0．2mg／kg分别复合布托啡诺0．14，0．16，0．18mg／kg加0．9％氯化钠稀释至100ml。在术后2，4，8，12，24h观察并记录视觉模拟量表（VAS）评分、Ramsay评分、PCIA给药次数、不良反应，计算出综合满意度。结果B组和C组PCIA方案能达到满意的镇痛效果，B、C组在术后4，8，12hVAS和Ramsay评分均优于A组（P〈0．05），A组在术后4，8h按压PCIA次数多于B、C组（P〈0．01），C组嗜睡人数多于A组和B组。B、C组满意度高于A组（P〈0．01）。结论地佐辛0．2mg／kg复合布托啡诺0．16mg／kg可以较好地用于下肢术后静脉镇痛。

Objective To study on analgesic of dezocine combined with different doses of butorphanol for postoperative patient-controlled intravenous analgesia （PCIA） after lower limbs surgery. Methods Ninety patients （20 - 55 years of age,ASA class Ⅰ or Ⅱ ） undergoing orthopaedic lower limbs surgery were randomly allocated into three groups with 30 cases each. The patients in group A received 0.2 mg/kg dezocine and 0.14 mg/kg butorphanol,in group B received 0.2 mg/kg dezocine and 0.16 mg/kg butorphanol, in group C received 0.2 mg/kg dezocine and 0.18 mg/kg butorphanol for PCIA. Observed the VAS scores, Ramsay scores after operation for 2,4,8,12,24 h, the times of PCIA and adverse reaction, calculated the degree of satisfaction. Results Adequate analgesia and sufficient sedation were achieved in group B and group C. The VAS scores and Ramsay scores in group B and group C were better than those in group A after operation for 4,8,12 h （P 〈 0.05 ）. The times of PCIA was requested more often in group A than that in group B and group C after operation for 4,8 h （P 〈 0.01 ）. The incidence of excessive sleep in group C was more often than that in group A and group B. The comprehensive satisfaction in group B and group C was higher than that in group A （P 〈 0.01 ）. Conclusion 0.2 mg/kg dezocine combined with 0.16 mg/kg butorphanol is good for postoperative PCIA after lower limbs surgery.