剖腹产术后舒芬太尼联合布托啡诺镇痛效果观察

Application of sufentanil combined with butorphanol in analgesia after caesarean section

目的术后疼痛严重影响产妇日常活动,不利于产后早期哺乳,是延迟剖宫产产妇术后恢复的重要原因。本研究观察舒芬太尼联合布托啡诺在剖宫产术后硬膜外镇痛中的应用效果,探讨其临床应用的有效性和安全性。方法选取2017-05-01-2018-05-01在辽河油田总医院实施剖宫产的160例产妇作为研究对象,根据硬币法分为对照组和研究组,各80例。对照组给予舒芬太尼、罗哌卡因、地塞米松及生理盐水进行镇痛,研究组给予舒芬太尼、布托啡诺、罗哌卡因、地塞米松及生理盐水进行镇痛,比较两组镇痛效果。结果两组术后3h镇痛效果评分差异无统计学意义,t=0.042,P=0.196;研究组术后6h评分为(2.41±0.36)分,优于对照组的(1.81±0.12)分,t=7.071,P<0.001;研究组术后12h评分为(2.11±0.34)分,优于对照组的(2.57±0.38)分,t=4.034,P<0.001;研究组术后24h评分为(2.21±0.35)分,优于对照组的(3.27±0.66)分,t=6.345,P<0.001;研究组术后36h评分为(2.31±0.39)分,优于对照组的(3.02±0.25)分,t=4.188,P<0.001。研究组不良反应发生率为3.75%(3/80),低于对照组的12.50%(10/80),差异有统计学意义,χ~2=4.102,P=0.048。结论舒芬太尼联合布托啡诺应用于剖宫产术后镇痛镇痛效果好、疼痛小、安全性高。

OBJECTIVE Postoperative pain is an important reason for delaying postoperative recovery in patients undergoing cesarean section.Postoperative pain,which seriously affects daily maternal activities,is not conducive to early postpartum breastfeeding.This study is to observe application effect of sufen and bupotone in extra-oral analgesia after cesarean section,and to explore the effectiveness and safety of its clinical application.METHODS Totally 160 patients who underwent cesarean section in Liaohe Oilfield General Hospital from May 1,2017 to May 1,2018 were selected as the study subjects.According to the coin method,they were divided into the control group and the research group,with 80 cases in each group.The control group received analgesia with sufen,ropivacaine,dexamethasone and saline.The study group received analgesia with sufen,butorphanol,ropivacaine,dexamethasone and saline.The analgesic effects of the two groups were compared.RESULTS There was no significant difference in the analgesic effect scores between the two groups at3 hafter operation(P>0.05).The scores of the study group after operation were(2.41±0.36),(2.11±0.34),(2.21±0.35)and(2.31±0.39)at 6 h,12 h,24 hand 36 h,respectively.They were better than those of the control group(1.81±0.12),(2.57±0.38),(3.27±0.66),(3.02±0.25),and the difference was statistically significant(t=7.071,4.034,6.345,4.188,all P<0.001).The incidence of adverse reactions in the study group was 3.75%,which was significantly lower than that in the control group(12.50%).The difference was statistically significant(χ~2=4.102,P=0.048).CONCLUSION The combination of Bhutto and butorphanol has a good analgesic effect,less pain and higher safety in cesarean section analgesia.