布托啡诺与舒芬太尼对肝胆外科非单纯胆囊切除术后疼痛的影响比较

Comparision on Effect of Butorphanol and Sufentanil on Postoperative Pain in Non-simple Cholecystectomy Patients in Hepatobiliary Surgery

目的比较布托啡诺和舒芬太尼对肝胆外科非单纯胆囊切除患者术后急性疼痛的影响。方法回顾性分析河南省人民医院肝胆外科2018年1月至2020年9月择期行手术治疗的2567例非单纯胆囊切除患者,根据术后阿片类镇痛药物种类分为布托啡诺组(B组)和舒芬太尼组(S组)。应用倾向评分匹配(PSM)的方法对两组患者的一般资料,包括年龄、性别、体重指数(BMI)、美国麻醉医师协会(ASA)、合并症、手术方式、麻醉方式、手术时间、液体输入量、出血量、尿量,以1∶1的比例进行倾向评分匹配。比较匹配之后两组患者术后中重度疼痛、不良反应发生情况以及术后住院时间。结果PSM后,B组术后中重度疼痛的发生率低于S组(P<0.05)。术后镇痛泵有效按压次数,B组低于S组(P<0.05)。术后1 d恶心发生率,S组高于B组(P<0.05)。两组术后2 d恶心发生率,术后1、2 d呕吐发生率,术后住院时间比较,差异无统计学意义(P>0.05)。结论与舒芬太尼相比,布托啡诺可减少肝胆外科非单纯胆囊切除患者术后急性疼痛的发生,是可用于肝胆外科非单纯胆囊切除术患者术后镇痛的阿片药物。

Objective To compare the effects of butorphanol and sufentanil on postoperative acute pain in non-simple cholecystectomy patients in Hepatobiliary Surgery.Methods A retrospective analysis was performed on 2567 patients with non-simple cholecystectomy in Hepatobiliary Surgery of Henan Provincial People’s Hospital from January 2018 to September 2020.The patients were divided into butorphanol group(group B)and sufentanil group(group S)according to postoperative opioid analgesic.Propensity score matching(PSM)method was used to match the general data of the two groups of patients,including age,gender,body mass index(BMI),American Society of Anesthesiologists(ASA),complications,operation mode,anesthesia mode,operation time,fluid input volume,blood loss volume and urine volume,with a ratio of 1∶1.The occurrence of moderate and severe postoperative pain,adverse reactions and the length of postoperative hospitalization were compared between the two groups after matching.Results After PSM,the incidence of moderate and severe postoperative pain in group B was lower than that in group S(P<0.05).The effective compression times of postoperative analgesic pump were lower in group B than in group S(P<0.05).The incidence of nausea on the first day after surgery was higher in group S than in group B(P<0.05).There were no differences in the incidence of nausea on the second day after surgery,the occurrence of vomiting on the first and second day after surgery,and the length of hospitalization after surgery between the two groups(P>0.05).Conclusion Compared with sufentanil,butorphanol can reduce the occurrence of postoperative acute pain in non-simple cholecystectomy patients in Hepatobiliary Surgery,and can be used as an opiate for postoperative analgesia in non-simple cholecystectomy patients in Hepatobiliary Surgery.