布托啡诺用于妇科肿瘤患者术后多模式镇痛临床研究被引量：13

Clinical research of Butorphanol for postoperative multimodal analgesia in patients with gynecologic tumor

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摘要目的探讨布托啡诺、氟比洛芬酯、舒芬太尼平衡镇痛用于妇科肿瘤患者术后静脉自控镇痛的有效性和安全性。方法 150例ASAⅠ或Ⅱ级在全身麻醉下开腹行妇科肿瘤手术的患者随机分为5组,每组30例。A组。布托啡诺8 mg;B组:布托啡诺6 mg+舒芬太尼50μg;C组:布托啡诺6 mg+氟比洛芬酯100 mg;D组:布托啡诺8 mg+氟比洛芬酯100 mg;E组:舒芬太尼100μg。5组镇痛药均以生理盐水稀释至100 mL用于术后患者自控镇痛。在手术结束时给予氟比洛芬酯50 mg负荷剂量。观察给药后2、6、12、24和48 h的视觉模拟评分、镇痛满意度以及48 h内恶心、呕吐、呼吸抑制、皮肤搔痒、尿潴留等不良反应的发生率。结果 5组间VAS评分和总体满意度差异无统计学意义(P>0.05),恶心、呕吐、瘙痒、呼吸抑制、异常出血、发热、大汗、头晕发生率差异无统计学意义(P>0.05),C组和E组镇静发生率显著低于其他组(P<0.05)。结论布托啡诺或舒芬太尼与氟比洛芬酯的平衡镇痛可安全有效地用于妇科肿瘤开腹手术术后急性疼痛治疗。【Objective】 To evaluate the efficacy and safety of balanced analgesic with combination of Butorphanol or Sulfentanil and Flurbiprofen for postoperative multi modal analgesia in patients with Gynecologic tumor undergoing abdominal operations. 【Methods】 One hundred and fifty ASA Ⅰ or Ⅱ patients with abdominal gynecologic tumor surgery under general anesthesia were randomly divided into five groups with thirty cases each： The patients in group A received Butorphanol 8 mg; group B received Butorphanol 6 mg in combination with Sulfentanil 50 ug; group C received Butorphanol 6 mg in combination with Flurbiprofen 100 mg; group D received Butorphanol 8 mg in combination with Flurbiprofen 100 mg and group E received Sulfentanil 100 ug. The analgesic drugs of each patient were diluted with normal saline to 100 mL. All patients received Flurbiprofen 50 mg as the loading dose, and followed by patient controlled intravenous analgesia（PCIA）. HR, MAP and respiratory rate were monitored in all patients. Visual analogue scale（VAS） score, satisfaction score and adverse effects were observed and recorded at preset time intervals. 【Results】 There were no significant differences in VAS score and satisfaction among five groups（P〉0.05）. During postoperative analgesia, the incidence of nausea, vomiting, itching, respiratory depression, abnormal bleeding, fever, sweating and dizziness of five groups was no significant difference（P〉0.05）. The incidence of sedation of group C and E was significantly lower compared to other groups during postoperative analgesia（P〉0.05）. 【Conclusion】 The balanced analgesia with combination of Butorphanol or Sulfentanil and Flurbiprofen may be safe and effective for acute postoperative pain management in patients with Gynecologic tumor undergoing abdominal operations.

作者周来影裴冬杰王喜梅潘坤云李靖怡王云姣郭曲练程智刚

机构地区中南大学湘雅医院麻醉科

出处《中国现代医学杂志》 CAS CSCD 北大核心 2014年第11期71-74,共4页 China Journal of Modern Medicine

关键词布托啡诺舒芬太尼氟比洛芬酯术后镇痛视觉模拟评分不良反应 Butorphanol Sulfentanil Flurbiprofen postoperative management visual analogue scale adverse effect

分类号 R619 [医药卫生—外科学]

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1BEYAZ SG,BAYAR F,ERDEM AF.Acute postoperative pain[J].J Anesth Clin Res,2011,4:288.doi:210.4172/2155-6148.1000286.
2DOLIN S,CASHMAN J,BLAND J.Effetiveness of acute postop-erative pain management:I.Evidence from published data[J].Br J Anaesth,2002,89(3):409-423.
3COMMISKEY S,FAN L-W,HO IK,et al.Butorphanol:effects of a prototypical agonist antagonist analgesic on K-opioid recep-tors[J].J Pharmacol Sci,2005,98(2):109-116.
4SARTON E,OLOFSEN E,ROMBERG R,et al.Sex differences in morphine analgesia:an experimental study in healthy volun-teers[J].Anesthesiology,2000,93(5):1245-1254.
5CRICHTON N.Visual analogue scale(VAS)[J].J Clin Nuts,2001,10(5):706-706.
6SIPPO W,GOMEZ A.Nerve-entrapment syndromes from lower abdominal surgery[J].J Fam Praet,1987,25(6):585.
7MOMENI M,CRUCITYI M,DE KOCK M.Patient-controlled analgesia in the management of postoperative pain[J].Drugs,2006,66(18):2321-2337.
8DABROWSKA-WDJCIAK I,PIOTROWSKI A.New opioids for general anaesthesia and in and out hospital analgesia [J].Anestezjol Intens Ter,2008,40(1):39.
9LIU ZF,CHAI XQ,CHEN KZ.Flurbiprofen axetil enhanees analgesic effect of fentanyl associated with increase in β-endor-phin levels[J].J Anesth,2011,25(5):679-684.
10CHU C,CHEN J,CHEN C,et al.The efficacy and safety of transnasal butorphanol for postoperalive pain control following lower laparoscopic surgery[J].Acta Anaesthesiol Taiwan,2004,42(4):203.