酮咯酸氨丁三醇复合酒石酸布托啡诺用于治疗骨折术后急性疼痛的临床效果观察

Clinical efficacy observation for ketorolac tromethamine combined with butorphanol tartrate in the treatment of acute postoperative fracture pain

目的比较单用酮咯酸氨丁三醇和酮咯酸氨丁三醇联合酒石酸布托啡诺用于治疗骨折术后急性疼痛的效果。方法 80例骨折术后急性疼痛患者,拟采用酮咯酸氨丁三醇或酮咯酸氨丁三醇联合酒石酸布托啡诺治疗,随机均分为两组。两组镇痛负荷剂量均为酮咯酸氨丁三醇30 mg。并继以2 ml/h静脉持续泵注酮咯酸氨丁三醇0.5 mg/kg（A组）及酮咯酸氨丁三醇0.25 mg/kg联合酒石酸布托啡诺10 mg（B组）。采用视觉模拟量表（VAS法）评分法评价给药前（T1）、给药后10 min、1 h、2 h、4 h、6 h（分别为T2、T3、T4、T5、T6）时的镇痛效果,并记录胃部不适、干呕或呕吐等不良反应的发生情况。结果与T1时点相比,两组T2、T3、T4、T5、T6时点VAS评分明显降低（P〈0.05）。与T2-T5时点相比,两组的VAS评分在T6时点升高（P〈0.05）。T6时点A组的VAS评分低于B组（P〈0.05）。B组胃部不适、干呕或呕吐等不良反应发生率明显低于A组（P〈0.05）。结论采用酮咯酸氨丁三醇酮或酮咯酸氨丁三醇联合酒石酸布托啡诺可有效控制骨折术后急性疼痛,其中酮咯酸氨丁三醇联合酒石酸布托啡诺的使用可明显降低相关不良反应发生率,但有效镇痛时间稍短。

Objective To compare the effects of the single use of ketorolac tromethamine and combined usage of ketorolac tromethamine and butorphanol tartrate on acute postoperative fracture pain. Methods Eighty patients with acute postoperative fracture pain subjected to the treatment of single use of ketorolac tromethamine or combination usage of ketorolac tromethamine with butorphanol tartrate were randomly and evenly divided into two groups. Loading analgesic dose in the two groups was 30 mg of ketorolac tromethamine. Ketorolac tromethamine 0. 5 mg / kg in group A and ketorolac tromethamine 0. 25 mg / kg combined with butorphanol tartrate 10 mg in group B were then continuously pumped with the rate of 2 ml / h. Visual analogue scale（ VAS） was used to evaluate the analgesic effects before administration（ T1） as well as 10 min,1 h,2 h,4 h,and 6 h after administration（ T2,T3,T4,T5,T6） respectively. The adverse reactions were also recorded. Results When compared with that at T1,VAS score at T2,T3,T4,T5,and T6 in the two groups both decreased significantly（ P〈0. 05）. VAS score at T6 was higher than that at T2- T5（ P〈0. 05） in both groups. VAS score at T6,but not at T1- T5,in group A was lower than that in group B（ P〈0. 05）. When compared with group A,there were less patients with stomach discomfort,vomit or nausea in group B（ P〈0. 05）. Conclusion Single use of ketorolac tromethamine and ketorolac tromethamine combined with butorphanol tartrate have good effect on acute postoperative fracture pain. Furthermore,the latter can reduce the incidence of stomach discomfort,vomit or nausea,as well as the effective analgesic period.