硬膜外和静脉注射布托啡诺预防阑尾牵拉反应的临床观察  

Efficacy of epidural versus intravenous butorphanol for reducing response to appendix retraction undergoing appendectomy

作　　者：谢致[1] 周守静[1] 沈雅芳[1] 

机构地区：[1]复旦大学附属华山医院麻醉科,上海200040

出　　处：《复旦学报（医学版）》2007年第4期592-594,共3页Fudan University Journal of Medical Sciences

摘　　要：目的观察并比较布托啡诺硬膜外与静脉两种给药途径对预防阑尾牵拉反应的效果。方法选择美国麻醉医师协会（ASA）Ⅰ~Ⅱ级在硬膜外阻滞下进行阑尾切除术的患者42例,随机分为硬膜外组与静脉组。在切皮时分别从硬膜外和静脉注射2mg布托啡诺,观察术中患者对牵拉阑尾的反应情况。结果硬膜外和静脉注射布托啡诺都有预防阑尾牵拉反应的效果,但硬膜外组优良率高于静脉组（P〈0.05）;两组病人注药后脉搏氧饱和度（SpO2）及平均动脉压（MAP）均稍降,静脉组下降明显,差异有显著性（P〈0.05）。硬膜外组不良反应较静脉组少。结论硬膜外注射2mg布托啡诺能有效预防阑尾牵拉反应。Purpose To evaluate and compare the clinical effects of epidural versus intravenous butorphanol for reducing the patient＇s response to appendix refraction undergoing appendectomy. Methods Forty-two adult patients, American Society of Anesthesiology（ASA） physical status class Ⅰ -Ⅱ , undergoing appendectomy during epidural anesthesia were divided randomly into two groups that received 2 mg butorphanol either epidurally （epidural group） or intravenously （intravenous group）. The patient＇s response to appendix retraction was evaluated during the operation. Results Either epidural or intravenous butorphanol could reduce the patient＇s response to appendix retraction, and epidural group significantly superior to intravenous group （P〈 0.05）. The patient＇s pulse oxygen satura- tion （SpO2） and mean arterial pressure （MAP） decreased slightly after butorphanol injection, and statistical difference was found in the intravenous group. The epidural group had fewer incidence of adverse events than intravenous group. Condusions Epidural butorphanol of 2 mg can reduce the patient＇s response to appendix retraction effectively.

关 键 词：硬膜外 静脉 布托啡诺 阑尾切除术 牵拉反应 

分 类 号：R614[医药卫生—麻醉学]