布托啡诺用于妇科腹腔镜术后静脉自控镇痛的效果观察

Butorphinol for intravenous patient-controlled analgesia after laparoscopic gynecological surgery

目的观察布托啡诺用于妇科腹腔镜术后静脉自控镇痛的效果。方法选取临海市第一人民医院2018年3月至2019年11月择期行妇科腹腔镜手术患者98例,按照随机数字表法分为对照组(n=49)和观察组(n=49),两组患者手术结束后均使用镇痛泵,对照组应用昂丹司琼,观察组使用昂丹司琼+布托啡诺镇痛。比较两组术后2 h、12 h、24 h视觉模拟评分法(VAS)评分、镇静(Ramsay)评分,比较两组手术完成时、术后30 min心率、收缩压、呼吸频率的变化,比较两组术后不良反应发生情况。结果观察组术后2 h、12 h、24 h的VAS评分分别为(1.27±0.50)分、(2.24±0.63)分、(1.71±0.55)分,均低于对照组的(1.52±0.47)分、(3.20±0.58)分、(2.23±0.59)分(t=2.55、7.84、4.51,均P<0.05),观察组术后2 h、12 h、24 h的Ramsay评分分别为(4.22±0.41)分、(3.22±0.43)分、(3.02±0.31)分,均高于对照组的(4.02±0.32)分、(3.01±0.27)分、(2.73±0.35)分(t=-2.69、-2.89、-4.34,均P<0.05)。两组手术完成时、术后30 min心率、收缩压、呼吸频率差异均无统计学意义(均P>0.05)。两组术后哌替啶使用率、术后不良反应发生率差异均无统计学意义(均P>0.05)。结论布托啡诺有助于提高妇科腹腔镜术后患者的镇痛和镇静效果,对患者的呼吸及循环影响较小。

Objective To investigate the analgesic effects of butorphinol used in intravenous patient-controlled analgesia after laparoscopic gynecological surgery.Methods Ninety-eight patients who underwent laparoscopic gynecological surgery in Linhai First People's Hospital between March 2018 and November 2019 were included in this study.They were randomly divided into control and observation groups,with 49 patients per group.After surgery,intravenous patient-controlled analgesia with either ondansetron(control group)or ondansetron combined with butorphanol(observation group).At 2,12 and 24 hours after surgery,visual analogue scale score and Ramsay sedation scale score were compared between the two groups.Heart rate,systolic blood pressure,and respiratory rate at 0 and 30 minutes after surgery were compared between the two groups.The incidences of postoperative adverse reactions were compared between the two groups.Results At 2,12 and 24 hours after surgery,visual analogue scale scores in the observation group were(1.27±0.50)points,(2.24±0.63)points,and(1.71±0.55)points respectively,which were significantly lower than(1.52±0.47)points,(3.20±0.58)points,(2.23±0.59)points in the control group(t=2.55,7.84,4.51,all P<0.05).At 2,12 and 24 hours after surgery,Ramsay sedation scale scores in the observation group were(4.22±0.41)points,(3.22±0.43)points,and(3.02±0.31)points,respectively,which were significantly higher than(4.02±0.32)points,(3.01±0.27)points,(2.73±0.35)points in the control group(t=-2.69,-2.89,-4.34,all P<0.05).There were no significant differences in heart rate,systolic blood pressure,and respiratory rate measured at 0 and 30 minutes after surgery between the two groups(all P>0.05).There were no significant differences in use of pethidine and the incidence of adverse reactions between the two groups(both P>0.05).Conclusion Butorphinol helps improve the analgesic and sedative effects after laparoscopic gynecological surgery and has little impact on patient's breathing and circulation.