摘要
目的探讨布托啡诺复合氟比洛芬酯用于剖宫产术后镇痛的效果和安全性。方法选择剖宫产产妇90例,ASAⅠ或Ⅱ级,随机均分为BF、LB和SB三组。术毕时均给予负荷量布托啡诺1mg静脉注射,随后行PCIA,三组布托啡诺用量分别为BF组4μg·kg-1·h-1、LB组5μg·kg-1·h-1、SB组4μg·kg-1·h-1;BF组在术毕时静注氟比洛芬酯50mg,每8小时一次,共2次。观察术后6、12、24和36h的切口疼痛VAS评分、宫缩痛评分和Ramsay镇静评分及术后36h内恶心呕吐和头晕的发生率。记录术后36h内PCA总次数、术后12h和12～36h内累计阴道出血量和缩宫素使用量,测量术后12和36h时的宫底高度。结果术后6、12和24h时,切口痛VAS和宫缩痛评分,BF组明显低于SB组和LB组(P<0.01或P<0.05),LB组明显低于SB组(P<0.05),Ramsay镇静评分BF组明显高于SB组(P<0.05),术后6、12、24和36h时Ramsay镇静评分LB组明显高于BF组和SB组(P<0.05或P<0.01)。LB组产妇头晕发生率明显高于SB组和BF组(P<0.05)。术后36hPCA总次数,BF组明显少于SB组和LB组(P<0.01或P<0.05),且LB组明显少于SB组(P<0.05)。结论布托啡诺4μg·kg-1·h-1PCIA复合氟比洛芬酯(50mg,每8小时一次,共2次)用于剖宫产术后镇痛,镇痛效果好,不影响子宫复旧和增加阴道出血量。
Objective To investigate the analgesic effect and the safety assessment of butorphanol combined with flurbiprofen axetil used for post-cesarean analgesia. Methods Ninety women （ASA I or II ） scheduled for elective cesarean delivery with epidural anesthesia were randomly divided into three groups,group BF, group LB and group SB. At the end of the surgery, butorphanol lmg was used intravenously as loading dose for analgesia in the three groups. Additional flurbiprofen axetil 50 mg was used intravenously every 8 hours two times in group BF. Then, butorphanol was injected continuously at doses of 4μg·kg^-1·h^-1 （groups SB and BF）, and 5 μg·kg^-1·h^-1（group LB） separately. The VAS scores of incision pain and uterine contraction pain scores, ramesay sedation scores, patient control analgesia （PCA） total times, side effects such as nausea and vomiting dizziness, fundus and vaginal blood loss at 12 h and 12-36 h were recorded. Results Within 24 h after surgery, the incision VAS scores and uterine contraction pain scores in group BF were less than that in groups SB and LB, and group LB were less than group SB（P〈0.05）. Ramesay sedation scores of group BF were higher than that of group SB（P〈0.05）, and lower than that of group LB （P 〈0.05）. The incidence of dizziness in group LB was higher than that in groups SB and BF （P〈 0.05）. The total times of PCA at 36 h after operation in group BF were less than that in groups SB and LB（P〈 0.01 or P 〈 0. 05）, and in group LB were less than that in group SB （P 〈0.05）. Conclusion Butophanol （4μg·kg^-1·h^-1 ） combined with flurhiprofen axetil （50 mg every 8 h for two times） for post-cesarean PCIA could provide better analgesic effect and decrease the dosage of butorphanol, without inhibiting uterus recovery or increasing vaginal blood loss significantly.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2013年第2期113-116,共4页
Journal of Clinical Anesthesiology
基金
江苏省高校自然科学研究计划项目(06KJD320130)
南京医科大学科技发展基金重点项目(06NMUZ028)
南京市医学科技发展重点项目(ZKX07021)
关键词
布托啡诺
氟比洛芬酯
剖宫产
术后镇痛
Butorphanol
Flurbiprofen axetil
Cesarean delivery
Postoperative analgesia
