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时间:2018-12-11
《布托啡诺与芬太尼用于剖宫产术后静脉镇痛(pcia) 临床效果观察》由会员上传分享,免费在线阅读,更多相关内容在应用文档-天天文库。
1、布托啡诺与芬太尼用于剖宫产术后静脉镇痛(PCIA)临床效果观察ClinicalObservationofButorphanolAndFentanylInPCIAForPostCesareanSection王久荣徐朝辉林林陈志勇王子千WANGJiurongXUChaohuiLINLinCHENZhiyongWANGZiqian天津市第一医院(中国300010)TianjinFirstHospital(China300010)中图分类号:R614.2+4文献标识码:A文章编号;1818-0086(2008)05摘要:目的观察
2、布托啡诺用于剖宫产术后病人自控静脉镇痛效果与副作用。方法选择ASAI~II级足月单胎妊娠产妇40例,随机分为两组,布托啡诺组(B组)及芬太尼组(F组),均选择小剂量氯胺酮静脉全麻进行剖宫产手术。术后分别给予布托啡诺9mg及芬太尼0.9mg分别用0.9%N.S稀释至100ml注入镇痛泵用于术后病人自控静脉镇痛。使用视觉模拟评分法(VAS)及镇静评分法Ramesay评分法,观察两组病人术后各时间段的疼痛评分、镇静评分以及术后恶心、呕吐情况。结果术后4h内两组VAS评分有显著差异,B组优于F组。两组术后各时间段的镇静评分:B组
3、高于F组,其差异有显著性。两组术后48小时以内恶心、呕吐、嗜睡的发生率比较均无统计学差异。结论本研究观察表明,布托啡诺与芬太尼均是安全的镇痛剂,用于剖宫产的病人术后的静脉镇痛效果确切,副作用少,且布托啡诺用于剖宫产术后静脉镇静效果优于芬太尼。关键词:布托啡诺;芬太尼;病人自控静脉镇痛(PCIA)Abstract:Objectivestoobserveandcomparetheefficacyandsafetybetweenbutorphanolandfentanylforpostcesareansectionwithpa
4、tientself-controlledintravenousanalgesia(PCIA).Methodsfortypatients(ASAⅠ-Ⅱ)undergoingcesareansectionwithsmalldoseketamineintravenousanesthesiawererandomlydividedintotwogroups.BgroupweregivenButorphanol9mginanalgesicpump,andFgroupweregivenfentanyl0.9mg.Postoperati
5、vepainwasassessedusingVAS(VisualAnalogueScore),sedationgradeswasassessedusingRamesayScoreandthesidereactions,suchasnausea,vomiting,wereobserved.ResultstheefficacyandsafetybetweenbutorphanolandfentanylforcesareansectionwithPCIAweresatisfied.TheVASscoresofstudygrou
6、pweresignificantlylessthangroupF(P<0.05),at4haftercesareansection.AndthesedationgradesgroupBweresignificantlyhigher(P<0.05).Theincidenceofnauseaandvomitingwassame.ConclusionbothbutorphanolandfentanylareeffectiveandsafeinPCIAforcesareansection.Thesectiongradesofbu
7、torphanolaremoreeffectivethanthatoffentanyl.Keywords:Butorphanol;Fentanyl;Patient-ControlledIntravenousAnalgesia(PCIA)术后病人自控静脉镇痛(PCIA,Patient-controlledIntravenousAnalgesia)对于剖宫产病人术后24-48小时的伤口疼痛及宫缩痛有着良好的效果,它能有效地减少围手术期的并发症,并大大提高围手术期安全。芬太尼为阿片类麻醉镇痛药,也是常用于术后镇痛的麻醉性镇痛药
8、。布托啡诺(Butorphanol)是混合型阿片受体激动-拮抗剂,对中枢κ受体的激动作用而产生镇痛,对μ受体为拮抗作用,其对σ受体活性很低。其镇痛效应强,镇痛时间久,呼吸抑制和成瘾性发生率较低[1]。本研究观察布托啡诺用于剖宫产术后病人自控静脉镇痛效果与副作用,并与芬太尼作一比较。1资料和方法一般资料选择ASAⅠ~Ⅱ
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