布托啡诺硬膜外镇痛的临床观察

Clinical Observation of Butorphanol in Epidural Analgesia after Surgery

目的:探讨布托啡诺用于术后硬膜外镇痛的临床疗效。方法:将80例剖宫产手术患者随机分为2组,每组40例,2组患者术后采用硬膜外镇痛,B组应用布托啡诺1mg复合0.167%左旋布比卡因,M组应用吗啡2mg复合0.167%左旋布比卡因,给药方式为负荷率+持续流量,用药48h,比较两组患者镇痛、镇静效果及不良反应发生情况。结果:两组患者术后(6、12、24、48)h各时间点VAS评分和Ramesay评分差异无统计学意义(P>0.05);B组患者术后恶心呕吐和皮肤瘙痒发生率低于M组(X2值分别为5.5411和5.5910,P<0.05),两组患者头晕发生率比较差异无统计学意义(X2=0.5123,P>0.05)。结论:布托啡诺应用于剖宫产术后硬膜外镇痛,不仅具有满意镇痛效果,还大大降低了恶心呕吐、皮肤瘙痒等不良反应发生率,能提高术后镇痛的质量。

Objective：To investigate the clinical effect of butorphanol in epidural analgesia after surgery.Methods：80 patients undergone cesarean operation were randomly divided into 2 groups,40 cases in each group,patients in 2 groups treated by epidural analgesia, group B treated with butorphanol 1mg combined with 0.167%levobupivacaine group M treated with morphine 2mg combined with 0.167%levobupivacaine, by means of load rate＋continuous flow with 48H, compared analgesic, sedative effect and adverse reactions of patients in two groups.Results：There were no significant difference of postoperative VAS score and Ramesay score of patients at different time points （6, 12, 24, 48）h （P〉0.05）;incidence rate of postoperative nausea vomiting and pruritus of patients in group B was lower than that of group M （X^2= 5.5411 and 5.5910, P〈0.05）,compared the rate of dizziness of patients in two groups ,there was no statistical significance （X2=0.5123, P〉0.05）.Conclusion：It has supply satisfactory analgesia with lower incidence rate of PONV and pruritus that Butorphanol used in epidural analgesia after cesarean operation, and it can improve quality of analgesia for postoperative patients.