小剂量布托菲诺对舒芬太尼用于患者术后静脉自控镇痛的影响

Effect of small-dose butorphanol on sufentanil intravenous patient-controlled analgesia after total abdominal hysterectomy

目的研究小剂量布托菲诺对舒芬太尼用于经腹全子宫切除术后患者静脉自控镇痛(patient controlled intravenous analgesia,PCIA)的影响。方法 60例经腹全子宫切除手术患者,随机分为舒芬太尼组(S组)和布托菲诺+舒芬太尼组(BS组),分别予舒芬太尼和小剂量布托菲诺+舒芬太尼术后静脉自控镇痛。评价比较两组患者术后3 h(T1)、6 h(T2)、12 h(T3)、24 h(T4)、48 h(T5)时的VAS(visual analogue score)镇痛评分、BCS(Bruggrmann comfort scale)舒适评分;评价比较两组11-point VNRS(11-point verbal numerical rating scale)恶心呕吐评分。结果 BS组患者在T1、T2、T3、T4时的VAS镇痛评分显著低于S组患者(P<0.05或0.01),BCS舒适评分显著高于S组患者(P<0.05或0.01);T5时两组患者VAS镇痛、BCS舒适评分差异无统计学意义;BS组患者11-point VNRS恶心呕吐评分显著低于S组患者(P<0.05)。结论小剂量布托菲诺可以增强患者术后舒芬太尼的镇痛效果,提高患者舒适度,并能够减轻术后恶心呕吐的发生。

Objective To evaluate the effect of small-dose butorphanol on sufentanil patient-controlled intravenous analgesia(PCIA)after total abdominal hysterectomy.Methods60patients undergoing total abdominal hysterectomies were enrolled to this randomized trial and assigned to either a sufentanil group(group S)or a sufentanil and butorphanol group(group BS).Patients were administered an PCIA of sufentanil or butorphanol combined with sufentanil.Visual analogue score(VAS)Bruggrmann comfort scale(BCS)were used to evaluate postoperative analgesia of two group of people after the surgery3hours(T1),6hours(T2),12hours(T3),24hours(T4),and48hours(T5).11-point verbal numerical rating scale(11-point VNRS)was used to assess postoperative nausea and vomiting(PONV).Results Compared to group S,VAS in group BS significantly decreased at T1,T2,T3,and T4(P<0.05or0.01).Group BS had obviously higher BCS than Group S at T1,T2,T3,and T4(P<0.05or0.01).There were no differences for VAS and BCS between two groups at T5.11-point VNRS was significantly lower in group BS than in group S(P<0.05).Conclusion Smalldose butorphanol can enhance analgesia of sufentanil,improve patients’comfort,and reduce nausea and vomiting after total abdominal hysterectomy.