丁丙诺啡加入局麻药用于臂丛神经阻滞的术后镇痛作用  

Buprenorphine added to the local anesthetic for brachial plexus block to provide postoperative analgesia

作　　者：徐文庆[1] 徐威[1] 陈建军[1] 李晓岩[1] 

机构地区：[1]上海复旦大学附属金山医院麻醉科,200540

出　　处：《临床麻醉学杂志》2005年第11期753-754,共2页Journal of Clinical Anesthesiology

摘　　要：目的观察丁丙诺啡加入局麻药用于臂丛神经阻滞对术后镇痛作用的影响.方法60例ASA Ⅰ～Ⅱ级在臂丛神经阻滞下手术患者,随机分为三组,每组20例,局麻药为0.25%布比卡因和1%利多卡因混合液20～25 ml,A组丁丙诺啡0.15 mg与局麻药混和用于臂丛神经阻滞;B组丁丙诺啡0.15 mg肌注;C组不用丁丙诺啡.记录术后3、9、12、24和48 h的视觉模拟评分(VAS),评估术后镇痛持续时间(术毕至术后VAS＞3分的时间),并注意各种不良反应.结果术后A组VAS明显低于B、C组(P＜0.01),镇痛时间A组为(35.06±2.68)h,B组为(8.09±2.36)h,C组为(7.85±1.54)h,A组显著高于B组和C组(P＜0.01),B组和C组相比无显著性差异(P＞0.05).不良反应A组和B组相比无显著性差异(P＞0.05).结论臂丛神经阻滞时加用丁丙诺啡能明显增强术后镇痛作用和延长术后镇痛时间,不良反应轻微.Objective To observe the postoperative analgesia produced by the addition of buprenorphine to local anesthetic in brachial plexus block. Methods Sixty ASA Ⅰ-Ⅱ patients scheduled for upper extremity surgery under brachial plexus block were randomly allocated into three groups. Group A （n=20） received 20-25 ml of the mixture solution of 0.25% bupivacaine and 1% lignocaine plus buprenorphine 0.15 mg for brachial plexus block, group B （n= 20） the same local anesthetic and intramuscularly buprenorphine 0.15 mg,and group C （n = 20） the same local anesthetic alone. The visual analogue scale （VAS） and side effects were evaluated at 3,9,12,24,48 h after operation. The analgesia was considered satisfactory if the score was 3 or less or if the patient was asleep. Results The VAS was significantly lower and the median duration of satisfactory analgesia lasted significantly longer in group A than those in group B and C（P〈0.01）. There were no significant difference between group A and B about the incidence of side effects. Conclusion The addition of buprenorphine to local anesthetic in brachial plexus block enhances and prolongs the analgesia.

关 键 词：丁丙诺啡 臂丛神经阻滞 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]