丁丙诺啡用于腹部手术后硬膜外镇痛的观察  

Clinical observation on the efficacy of buprenorphine for postoperative epidural analgesia in patients undergoing abdominal surgery

作　　者：刘兰萍[1] 马民玉[1] 冉菊红[1] 

机构地区：[1]郑州大学第一附属医院麻醉科,郑州450052

出　　处：《中原医刊》2006年第19期13-14,共2页Central Plains Medical Journal

摘　　要：目的 观察硬膜外注射丁丙诺啡用于腹部手术后的镇痛效果以及其对循环、呼吸功能的影响及不良反应。方法 选择60例连续硬膜外麻醉下行腹部手术患者，ASAI～Ⅱ级，随机分为两组，Ⅰ组（丁丙诺啡组）30例，Ⅱ组（吗啡组）30例。于关腹时，Ⅰ组将丁丙诺啡0．05mg用生理盐水稀释至10ml，Ⅱ组将吗啡2mg用生理盐水稀释至10ml，均一次性缓慢注入硬膜外腔。用Prince Hennry评分评价用药后4、8、12、24、36h的疼痛程度；监测用药后相同时点的平均动脉压（MAP）、心率（HR）、呼吸频率（RR）、脉搏血氧饱和度（SpO2）和心电图（ECG）变化；同时记录镇痛期间不良反应的发生情况。结果两组镇痛评分均小于2，镇痛满意率为100％。术后镇痛期间呼吸、循环功能均稳定。Ⅰ组不良反应发生率低于Ⅱ组。结论 术后硬膜外腔注入丁丙诺啡0．05mg可提供确切的镇痛效果，是一种安全、有效和简便可行的术后镇痛方法。Objective To observe the efficacy of buprenorphine for postoperative epidural analgesia in patients undergoing abdominal surgery. Methods Sixty patients （ASA Ⅰ～Ⅱ ） scheduled to undergo abdominal surgery under continuous epidural anesthesia were randomly divided into two groups ：group Ⅰ（buprenorphine group, n = 30） and group H （morphine group, n = 30）. When closing the abdominal cavity, patients were given epiduraIly： buprenorphine （0.05mg, group Ⅰ ） and morphine （2mg, group Ⅱ） were diluted for 10ml with 0.9% NaCl. The analgesic score at 4,8,12,24 and 36 hours after injection were assessed by Prine Hennry Scale. The MAP, HR, RR,SpO2 and ECG were monitored. The adverse reaction were also recorded at the same time-points. Results In two groups , the analgesic score were less than 2, the superior rate of analgesia were 100% ,the respiratory and circulative functions of patients were stable during analgesia. In group Ⅰ the incidence of adverse reaction is lower than that in group Ⅱ. Conclusion The postoperative analgesic effect of epidural injection of 0.05mg buprenorphine is definite. It is a safe, effective, simple and feasible method for postoperative pain.

关 键 词：丁丙诺啡 硬脊膜外腔 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]