不同剂量布托啡诺复合芬太尼用于全身麻醉患者术后镇痛的临床研究
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摘要
目的探讨不同剂量布托啡诺复合芬太尼对全身麻醉患者术后镇痛效果的影响。方法选择2014年3月至2015年3月中山市黄圃人民医院收治的96例全身麻醉患者为研究对象,按照随机数字法分为布托啡诺联合芬太尼组1(BF1组)、布托啡诺联合芬太尼组2(BF2组)、芬太尼组(F组),各32例。BF1组采取布托啡诺6 mg进行与芬太尼0.6 mg进行静脉自控镇痛(PCIA);BF2组行布托啡诺4 mg与芬太尼0.8 mg进行PCIA;F组单用芬太尼1.0 mg进行PCIA。对三组患者术后镇痛效果及安全性进行分析。结果术后12 h,三组VAS评分开始下降,术后24 h、48 h,三组VAS评分趋于平稳,BF1组与BF2组VAS评分低于F组,BF1组低于BF2组,组间、时点间、组间·时点间交互作用差异有统计学意义(P<0.01)。BF1组不良反应发生率为9.4%(3/32),BF2组为28.1%(9/32),F组为46.9%(15/32),BF1组与BF2组均低于F组,BF1组低于BF2组(P<0.05)。结论布托啡诺6 mg+芬太尼0.6 mg进行PCIA的镇痛效果显著,安全性高,可有效控制术后疼痛强度,缓解患者痛苦,值得推广。
Objective To investigate the effect of different doses of butorphanolcombined with fentanyl on postoperative analgesia in patients with general anesthesia.Methods From Mar.2014 to Mar.2015,96 cases of general anesthesia admitted to Zhongshan Huangpu People's Hospital were included as the research objects,according to random number table method they were divided into a BF1 group(n=32) and a BF2 group(n=32) and a F group(n=32);The BF1 group adopted butorphanol 6 mg and fentanyl 0.6 mg by patient-controlled intravenous analgesia(PCIA);the BF2 group received butorphanol 4 mg and fentanyl 0.8 mg by PCIA;the F group received fentanyl 1.0 mg by PCIA.Postoperative analgesia effect and safety of the three groups were analyzed.Results Postoperative 12 h,three groups' VAS score began to decline;after 24 h,48 h,three groups' VAS score became stable,but the BF1 group and BF2 group were lower than the F group,and BF1 group lower than BF2 group,there were significant differences between groups,different time points and the interaction of groups·time points(P<0.01).The incidence of adverse reactions in the BF1 group was 9.4%(3/32),in the BF2 group was 28.1%(9/32),and in the F group was 46.9%(15/32),BF1 group and BF2 group were lower than the F group,BF1 group lower than BF2 group(P<0.05).Conclusion Butorphanol 6 mg+fentanyl 0.6 mg by PCIA has remarkable analgesic effect and high safety,which can effectively control postoperative pain intensity and alleviate the suffering of the patients,thus is worth of promotion.
Objective To investigate the effect of different doses of butorphanolcombined with fentanyl on postoperative analgesia in patients with general anesthesia.Methods From Mar.2014 to Mar.2015,96 cases of general anesthesia admitted to Zhongshan Huangpu People's Hospital were included as the research objects,according to random number table method they were divided into a BF1 group(n=32) and a BF2 group(n=32) and a F group(n=32);The BF1 group adopted butorphanol 6 mg and fentanyl 0.6 mg by patient-controlled intravenous analgesia(PCIA);the BF2 group received butorphanol 4 mg and fentanyl 0.8 mg by PCIA;the F group received fentanyl 1.0 mg by PCIA.Postoperative analgesia effect and safety of the three groups were analyzed.Results Postoperative 12 h,three groups' VAS score began to decline;after 24 h,48 h,three groups' VAS score became stable,but the BF1 group and BF2 group were lower than the F group,and BF1 group lower than BF2 group,there were significant differences between groups,different time points and the interaction of groups·time points(P<0.01).The incidence of adverse reactions in the BF1 group was 9.4%(3/32),in the BF2 group was 28.1%(9/32),and in the F group was 46.9%(15/32),BF1 group and BF2 group were lower than the F group,BF1 group lower than BF2 group(P<0.05).Conclusion Butorphanol 6 mg+fentanyl 0.6 mg by PCIA has remarkable analgesic effect and high safety,which can effectively control postoperative pain intensity and alleviate the suffering of the patients,thus is worth of promotion.
引文
[1]郑书芬.布托啡诺联合芬太尼用于脊柱融合手术后自控镇痛的观察[J].浙江医学,2012,34(3):221-223.
[2]刘锴,夏中元,王鄂友.不同剂量布托啡诺复合芬太尼用于全麻术后静脉镇痛的临床观察[J].数理医药学杂志,2008,21(6):681-682.
[3]郭荟楠,郭海云,郭永清.术后镇痛泵的使用[J].中国药物与临床,2013,13(z1):40.
[4]杨舒欣.医用镇痛泵技术新发展及其应用[J].医疗卫生装备,2012,33(6):82-84.
[5]李佳,黄井林.酒石酸布托啡诺注射液与曲马多复合舒芬太尼术后自控镇痛效果比较[J].实用医院临床杂志,2013,10(2):142-143.
[6]李彦新.布托啡诺、芬太尼复合局麻药用于臂丛神经阻滞的效果比较[J].河南外科学杂志,2014,20(3):58-59.
[7]王文辉,陈芳,范云霞.布托啡诺用于术后病人静脉镇痛的效果观察[J].实用临床医学,2006,7(5):130.
[8]李双凤,王亚平,王丹,等.布托啡诺或曲马多复合芬太尼用于全麻术后镇痛的临床效果比较[J].中国现代手术学杂志,2011,15(2):148-151.
[9]刘彬,李蕾,王保国,等.布托啡诺在神经外科术后镇痛中的应用研究[J/CD].中华临床医师杂志(电子版),2012,6(24):8136-8138.
[10]谢壮壮,王莹.酒石酸布托菲诺静脉辅助臂丛神经阻滞用于手外科患者术后不良反应的探讨[J].河北医科大学学报,2012,33(2):223-225.
[11]周来影,裴冬杰,王喜梅,等.布托啡诺用于妇科肿瘤患者术后多模式镇痛临床研究[J].中国现代医学杂志,2014,24(11):71-74.
[12]谢恒韬,孙倩,贾强,等.不同剂量布托啡诺用于全身麻醉术后静脉自控镇痛的临床研究[J].贵阳中医学院学报,2013,35(5):198-200.
[13]赵敏,夏海杰,吴安生,等.布托啡诺复合芬太尼用于老年患者术后静脉镇痛的临床疗效评价[J].浙江医学,2011,33(6):916-917.
[14]陈其标.布托啡诺与氟比洛芬酯复合芬太尼用于腹腔镜术后静脉镇痛的对比[J].医学信息(中旬刊),2010,5(6):1545-1546.
[15]詹亚新.舒芬太尼与布托啡诺联合用于高龄患者术后镇痛的疗效研究[J].中国现代药物应用,2012,6(12):23-24.
[16]顾天玉,张靖,杨雪峰.布托啡诺联合芬太尼用于腹腔镜胆囊切除术后自控镇痛的临床观察[J].南通大学学报(医学版),2012,32(2):136-137.
[17]Parikh GP,Veena SR,Vora K,et al.Comparison of epidural butorphanol versus epidural morphine in postoperative pain relief[J].Middle East J Anaesthesiol,2014,22(4):371-376.
[18]阮履强,王利洋,王洪阳,等.布托啡诺复合舒芬太尼用于脊柱外科术后静脉镇痛的临床观察[J].西部医学,2013,25(8):1181-1182,1185.
[2]刘锴,夏中元,王鄂友.不同剂量布托啡诺复合芬太尼用于全麻术后静脉镇痛的临床观察[J].数理医药学杂志,2008,21(6):681-682.
[3]郭荟楠,郭海云,郭永清.术后镇痛泵的使用[J].中国药物与临床,2013,13(z1):40.
[4]杨舒欣.医用镇痛泵技术新发展及其应用[J].医疗卫生装备,2012,33(6):82-84.
[5]李佳,黄井林.酒石酸布托啡诺注射液与曲马多复合舒芬太尼术后自控镇痛效果比较[J].实用医院临床杂志,2013,10(2):142-143.
[6]李彦新.布托啡诺、芬太尼复合局麻药用于臂丛神经阻滞的效果比较[J].河南外科学杂志,2014,20(3):58-59.
[7]王文辉,陈芳,范云霞.布托啡诺用于术后病人静脉镇痛的效果观察[J].实用临床医学,2006,7(5):130.
[8]李双凤,王亚平,王丹,等.布托啡诺或曲马多复合芬太尼用于全麻术后镇痛的临床效果比较[J].中国现代手术学杂志,2011,15(2):148-151.
[9]刘彬,李蕾,王保国,等.布托啡诺在神经外科术后镇痛中的应用研究[J/CD].中华临床医师杂志(电子版),2012,6(24):8136-8138.
[10]谢壮壮,王莹.酒石酸布托菲诺静脉辅助臂丛神经阻滞用于手外科患者术后不良反应的探讨[J].河北医科大学学报,2012,33(2):223-225.
[11]周来影,裴冬杰,王喜梅,等.布托啡诺用于妇科肿瘤患者术后多模式镇痛临床研究[J].中国现代医学杂志,2014,24(11):71-74.
[12]谢恒韬,孙倩,贾强,等.不同剂量布托啡诺用于全身麻醉术后静脉自控镇痛的临床研究[J].贵阳中医学院学报,2013,35(5):198-200.
[13]赵敏,夏海杰,吴安生,等.布托啡诺复合芬太尼用于老年患者术后静脉镇痛的临床疗效评价[J].浙江医学,2011,33(6):916-917.
[14]陈其标.布托啡诺与氟比洛芬酯复合芬太尼用于腹腔镜术后静脉镇痛的对比[J].医学信息(中旬刊),2010,5(6):1545-1546.
[15]詹亚新.舒芬太尼与布托啡诺联合用于高龄患者术后镇痛的疗效研究[J].中国现代药物应用,2012,6(12):23-24.
[16]顾天玉,张靖,杨雪峰.布托啡诺联合芬太尼用于腹腔镜胆囊切除术后自控镇痛的临床观察[J].南通大学学报(医学版),2012,32(2):136-137.
[17]Parikh GP,Veena SR,Vora K,et al.Comparison of epidural butorphanol versus epidural morphine in postoperative pain relief[J].Middle East J Anaesthesiol,2014,22(4):371-376.
[18]阮履强,王利洋,王洪阳,等.布托啡诺复合舒芬太尼用于脊柱外科术后静脉镇痛的临床观察[J].西部医学,2013,25(8):1181-1182,1185.