布托啡诺联合右美托咪定在重症急性胰腺炎患者中的应用

Application of butorphanol combined with dexmedetomidine in patients with severe acute pancreatitis

目的探讨布托啡诺联合右美托咪定在重症急性胰腺炎(SAP)患者中的镇痛镇静效果。方法将2017年1月至2022年10月空军军医大学西京医院重症医学科收治的符合入组标准的SAP患者63例纳入本研究。布托啡诺联合右美托咪定组28例(A组),芬太尼联合右美托咪定组35例(B组)。观察两组间镇静镇痛效果及预后的影响。将两组患者心率、呼吸、Richmond躁动镇静评分(RASS)以及重症监护疼痛观察量表(CPOT)及胃残余量进行对比。结果统计分析发现,A组患者心率、呼吸频率、CPOT评分、RASS评分及胃残余量较B组均降低,差异均有统计学意义[(82.16±7.41)次/min vs(104.64±10.30)次/min,(19.43±3.92)次/min vs(27.18±4.21)次/min,(0.94±0.31)分vs(2.32±0.35)分,(1.20±0.44)分vs(0.91±0.47)分,(89.74±12.28)mL vs(142.43±18.57)mL]。结论对SAP患者采用布托啡诺联合右美托咪定方案镇痛镇静效果确切有效,并发症较少,可提高临床治疗效果,血流动力学稳定,安全性较高,值得临床推广应用。

Objective To discuss the analgesic and sedative effects of butorphanol combined with dexmedetomidine in patients with severe acute pancreatitis(SAP).Methods Sixty-three SAP patients who met the inclusion criteria admitted to Department of Critical Care Medicine,Xijing Hospital,Air Force Medical University from January 2017 to October 2022 were included in this study.Analgesic,sedative,and prognostic effects of patients between group A(butorphanol combined with dexmedetomidine,n=28)and group B(fentanyl combined with dexmedetomidine,n=35)were observed.Heart rate,respiratory rate,Richmond Agitation-Sedation Scale(RASS)score,Critical-Care Pain Observation Tool(CPOT)score,and gastric residual volume were compared between the two groups.Results Statistical analyses showed that heart rate,respiratory rate,CPOT score,RASS score and gastric residual volume in group A were lower than those in group B,and the differences were statistically significant[(82.16±7.41)times/min vs(104.64±10.30)times/min,(19.43±3.92)times/min vs(27.18±4.21)times/min,(0.94±0.31)points vs(2.32±0.35)points,(1.20±0.44)points vs(0.91±0.47)points,and(89.74±12.28)mL vs(142.43±18.57)mL].Conclusion For SAP patients,butorphanol combined with dexmedetomidine has definite and effective analgesic and sedative effects,with fewer complications,better clinical therapeutic effects and stable hemodynamics,which is worthy of clinical application.