羟考酮与布托啡诺用于剖宫产术后补救镇痛的安全性与有效性比较

Efficacy and safety of oxycodone and butorphanol for remedial analgesia in parturients after cesarean

目的比较盐酸羟考酮与布托啡诺用于剖宫产术后疼痛的补救性镇痛治疗的安全性及有效性。方法 40例行剖宫产术的单胎足月产妇,年龄25岁～40岁,ASAⅠ～Ⅱ级,BMI≤35 kg/m2,VAS评分大于4分申请补救性镇痛患者。依数字表法均分为两组,0组:滴定给予盐酸羟考酮0. 1 mg/kg,B组滴定给予酒石酸布托啡诺0. 02 mg/kg,观察患者基本生命体征,镇痛评分,记录给药后不良反应发生情况及患者的满意度。结果两组患者给药前后及两组间血压、心率、血氧饱和度比较差异无统计学意义(P> 0. 05);与T0相比,O组在T1、T2、T3、T4、T5时点静息、运动、内脏VAS评分均降低,B组在T2、T3时点静息VAS评分降低,T2、T3、T4时点运动及内脏痛VAS评分降低;与B组相比,O组在T1、T2、T3、T4、T5时点静息、运动、内脏痛VAS评分均降低;O组患者有4例轻微头晕,2例恶心,B组患者有3例有头晕,1例出现恶心,两组间比较无差异(P> 0. 05);O组患者满意度更高。结论羟考酮用于剖宫产术后补救性镇痛,起效更快,VAS评分降低更明显,患者满意度更高。

Objective To compare the efficacy and safety of oxycodone and butorphanol for remedial analgesia in parturients after cesarean section.Methods Forty patients underwent cesarean section of singletons full -term birth,ASA Ⅰ or Ⅱ ,aged 25to 40years old,BMI≤35kg/m^2,VAS score was greater than 4points and appled for remedial analgesia were randomly divided into 2 groups :group O:titration oxycodone hydrochloride for 0.1mg/kg,group B :titration butorphanol Tartrate for 0.02mg/kg,the basic vital signs and pain score were observed and the adverse reactions occurred after the treatment and patients' satisfaction were recorded.Results There was no significant difference in blood pressure,heart rate,blood oxygen saturation between the two groups and before and after dosing(P >0.05).Compared with TO,the resting,sports,visceral VAS scores of group O was significantly lower in T1,T2,T3,T4and T5,the resting VAS score was significantly lower in T2,T3 and the movement and visceral pain VAS score were lower in T2,T3,T4; the resting,sports,visceral pain VAS score of group O were significantly lower in T1,T2,T3,T4 and T5than group B ;There were no significant difference in serious adverse event occurred :4 cases of patients with mild dizziness and 2 cases of nausea were occured in group O and 3 cases with dizziness,and 1 case of nausea,were in group B (P >0.05); the satisfaction is higher in group O.Conclusion For remedial analgesia after cesarean section,with work faster,VAS score lower and satisfaction higher,oxycodone do well than butorphanol.