布托啡诺联合右美托咪定对创伤性颅脑损伤患者镇痛效果的评价

Analgesic effect of Butorphanol combined with Dexmedetomidine in patients with traumatic brain injury

目的观察布托啡诺联合右美托咪定对创伤性颅脑损伤(TBI)患者的镇痛效果,为临床治疗提供依据.方法2018年1至5月在温州医科大学附属第二医院急诊ICU(EICU)收治的TBI患者60例,按随机数字表法分成2组,每组30例.布托啡诺组患者给予布托啡诺联合右美托咪定镇痛镇静,芬太尼组患者给予芬太尼联合右美托咪定治疗.收集并分析2组患者急性生理与慢性健康评分、格拉斯哥昏迷评分等临床指标.结果经治疗,布托啡诺组患者的心率、呼吸频率、重症监护疼痛观察量表疼痛评分及发生营养液潴留比例较芬太尼组均降低,差异均有统计学意义[(85.51±9.41)次/minvs(114.63±12.23)次/min,(23.41±3.92)次/minvs(33.87±5.12)次/min,(0.91±0.34)分vs(2.11±0.39)分,10.0%vs36.7%,均P<0.05],氧分压升高[(96.21±10.51)mmHgvs(74.18±8.54)mmHg,P<0.05],其他指标无明显差异.结论布托啡诺联系右美托咪定应用于ICUTBI患者有良好的镇痛效果,并发症较少.

Objective To observe the analgesic effect of Butorphanol combined with Dexmedetomidine in patients with traumatic brain injury (TBI), providing evidence for clinical treatment of TBI. Methods 60 Patients with TBI admitted to the EICU between January 2018 and May 2018 were included and divided into two groups, the Butorphanol group (30 cases) and the Fentanyl group (30 cases), with a random number table. Patients in the Butorphanol group were treated with Butorphanol plus Dexmedetomidine and those in the Fentanyl group were treated with Fentanyl plus Dexmedetomidine for analgesia and sedation. Clinical indicators including APACHE Ⅱ and GCS scores were recorded and comparatively analyzed for the two groups. Results After treatment, the heart rate, respiration frequency, pain scores and the rate of nutrient retention of the patients in the Butorphanol group were lower than those of the Fentanyl group [(85.51±9.41) times/min vs (114.63±12.23) times/min,(23.41±3.92) times/min vs (33.87±5.12) times/min,(0.91±0.34) scores vs (2.11±0.39) scores, 10.0% vs 36.7%, all P < 0.05], and the oxygen pressure was higher than that of the Fentanyl group [(96.21±10.51) mmHg vs (74.18± 8.54) mmHg, P < 0. 05]. No significant differences in other indicators were observed between the two groups. Conclusion Butorphanol combined with Dexmedetomidine is effective in patients with TBI in ICU with favorable analgesic effect and few complications.