不同剂量布托啡诺复合芬太尼用于全身麻醉患者术后镇痛的临床研究

Clinical Study of Different Doses of Butorphanol Combined with Fentanyl for Postoperative Analgesia in Patients Undergoing General Anesthesia

目的探讨不同剂量布托啡诺复合芬太尼对全身麻醉患者术后镇痛效果的影响。方法选择2014年3月至2015年3月中山市黄圃人民医院收治的96例全身麻醉患者为研究对象,按照随机数字法分为布托啡诺联合芬太尼组1(BF1组)、布托啡诺联合芬太尼组2(BF2组)、芬太尼组(F组),各32例。BF1组采取布托啡诺6 mg进行与芬太尼0.6 mg进行静脉自控镇痛(PCIA);BF2组行布托啡诺4 mg与芬太尼0.8 mg进行PCIA;F组单用芬太尼1.0 mg进行PCIA。对三组患者术后镇痛效果及安全性进行分析。结果术后12 h,三组VAS评分开始下降,术后24 h、48 h,三组VAS评分趋于平稳,BF1组与BF2组VAS评分低于F组,BF1组低于BF2组,组间、时点间、组间·时点间交互作用差异有统计学意义(P<0.01)。BF1组不良反应发生率为9.4%(3/32),BF2组为28.1%(9/32),F组为46.9%(15/32),BF1组与BF2组均低于F组,BF1组低于BF2组(P<0.05)。结论布托啡诺6 mg+芬太尼0.6 mg进行PCIA的镇痛效果显著,安全性高,可有效控制术后疼痛强度,缓解患者痛苦,值得推广。

Objective To investigate the effect of different doses of butorphanolcombined with fentanyl on postoperative analgesia in patients with general anesthesia. Methods From Mar. 2014 to Mar. 2015,96 cases of general anesthesia admitted to Zhongshan Huangpu People＇s Hospital were included as the research objects, according to random number table method they were divided into a BF1 group （ n = 32） and a BF2 group （ n = 32 ） and a F group （ n = 32 ） ; The BF1 group adopted butorphanol 6 mg and fentanyl 0. 6 mg by patient-controlled intravenous analgesia（PCIA） ;the BF2 group received butorphanol 4 mg and fentanyl 0. 8 mg by PCIA; the F group received fentanyl 1.0 mg by PCIA. Postoperative analgesia effect and safety of the three groups were analyzed, Results Postoperative 12 h, three groups＇ VAS score began to decline; after 24 h, 48 h,three groups＇ VAS score became stable,but the BF1 group and BF2 group were lower than the F group, and BF1 group lower than BF2 group, there were significant differences between groups, different time points and the inter- action of groups ~ time points （P 〈0. O1 ）. The incidence of adverse reactions in the BF1 group was 9.4% （3/32） ,in the BF2 group was 28. 1% （9/32） ,and in the F group was 46. 9% （15/32） ,BF1 group and BF2 group were lower than the F group, BF1 group lower than BF2 group （ P 〈 0. 05 ）. Conclusion Butorphanol 6 mg ＋ fentanyl 0. 6 mg by PCIA has remarkable analgesic effect and high safety ,which can effectively control postoperative pain intensity and alleviate the suffer- ing of the patients ,thus is worth of promotion.