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布托啡诺联合舒芬太尼用于妇科术后静脉自控镇痛的效果
The effects of the butorphanol combined with sufentanil used in gynecologic postoperative patient-controlled intravenous analgesia
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DOI:
作者:
王苑 , 徐韬 ,余大松 , 安小虎
WANG Yuan,XU Tao,YU Dasong ,AN Xiaohu
作者单位:
国际和平妇幼保健院 麻醉科
International peace mother and child care hospital, Medical college of Shanghai Jiaotong University
关键词:
布托啡诺;舒芬太尼;妇科手术;静脉自控镇痛
Butorphanol; Sufentanil; Gynecologic operation; Controlled intravenous analgesia
摘要:
【摘要】 目的 观察布托啡诺联合舒芬太尼用于妇科手术后静脉自控镇痛的效果 方法 择期全麻下行妇科开腹手术的患者150例,ASA Ⅰ~Ⅱ级,随机均分为3组,布托啡诺组(B组,n=50例),镇痛药物为布托啡诺12mg;布托啡诺加舒芬太尼组(BS组,n=50例),镇痛药物为布托啡诺8mg+舒芬太尼50ug;舒芬太尼组(S组,n=50例),镇痛药物为舒芬太尼150ug;三组均加入氟哌啶2.5mg,用生理盐水稀释到100ml;PCIA 设置相同。观察术后48h内患者的VAS、Ramsay镇静评分和指脉血氧饱和度(SpO2),副作用如恶心呕吐、瘙痒、嗜睡、寒颤等。结果 三组患者均获得了良好的镇痛效果,观察期间没有患者需要额外的止痛药物治疗疼痛; B组在镇痛早期VAS评分较S组和BS组相同时间点高,PCA按压次数也较S组和BS组多(P<0.05),同时有5例患者出现嗜睡, Ramsay镇静评分B组高于S组和BS组(P<0.05);S组有7例患者出现恶心呕吐,3例患者出现程度不同的皮肤瘙痒(P<0.01,P<0.05),和另外两组比较有较显著性差异; B组另有2例出现SpO2低于95%的现象,经吸氧后得以纠正;S组一例患者出现寒颤,未处理,自行缓解。 结论 三组方法均能提供满意的镇痛效果,布托啡诺联合舒芬太尼组镇痛效果确切,且副作用更少,有更好的推广价值。
[Abstract] Objective To observe the effects of the butorphanol combined with sufentanil used in patient-controlled intravenous analgesia(PCIA) of gynecologic postoperative. Methods 150 patients,selective gynecologic celiotomy under general anesthesia, ASAⅠ~Ⅱ,were randomly divided into 3 groups: butorphanol group ( group B n=50) , with butorphanol 12mg; Butorphanol combined with sufentanil group ( group BS n=50) ,with butorphanol 8mg and sufentanil 50ug;Sufentanil group (group S n=50) ,with sufentanil 150ug;three groups were joined droperidol 2.5mg,diluted with saline to 100ml; set the same pattem of PCIA. The patients were observed with VAS, Ramsay sedation score and finger pulse oxygen saturation ( SpO2 ) ,side effects such as nausea and vomiting,pruritus, sleepiness, chills in 48 hours. Results Three groups of patients were obtained good analgesic effect, during the observation period, none of the patients needed additional analgesic drugs in the treatment of pain; the group B in early VAS score was higher compared with group S and group BS at the same time, and the presses the number of PCA were more than the group S and the group BS (P<0.05),5 patients of group B appeared drowsiness, Ramsay sedation score of group B was higher than group S and group BS (P<0.05) ; in group S,7 patients appeared nausea and vomiting,3 patients appeared different degrees of pruritus ( P<0.01, P<0.05 ) ,compared with the other two groups;there were 2 patients with SpO2 below 95% phenomenon in group B,after inhalation of oxygen they were corrected; one patient had chills in group S,untreated,relieve herself. Conclusion The three groups were able to provide satisfactory analgesia effect, the analgesic effect in group BS was proved precise and had less side effects,better promotion value.
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