布托啡诺用于老年病人术后自控静脉镇痛的疗效观察  

Effect of Butorphanol on Elderly Patients in Patient-Controlled Intravenous Analgesia

作　　者：张福清[1] 陈国忠[2] 聂海贵[1] 吴恩慧[1] 

机构地区：[1]解放军南京军区福州总医院476临床部麻醉科,福建福州350002 [2]解放军南京军区福州总医院麻醉科,福建福州350025

出　　处：《临床军医杂志》2008年第6期869-871,共3页Clinical Journal of Medical Officers

摘　　要：目的比较布托啡诺、曲马多、哌替啶、布托啡诺复合哌替啶在老年人术后的镇痛效果。方法120名行腹部和下肢手术的老年患者，随机分为四组进行术后镇痛：布托啡诺组（B组）、曲马多组（T组）、哌替啶组（M组）和布托啡诺复合哌替啶组（B＋M组）。所有患者在术毕前10-30min静脉注入负荷量，分别注入布托啡诺1mg、曲马多50mg、哌替啶50mg、布托啡诺0．5mg＋哌替啶25mg，按双盲原则进行观察，镇痛程度使用视觉疼痛评分。结果各组患者手术后不同时间点的血压、心率、呼吸频率差异均无统计学意义（P〉0．05），对手术后各组不同时间点VAS评分进行比较，发现6h和12h2个时间点B组、B＋M组和其他两组相比较差异有统计学意义（P〈0．05），B组的恶心、呕吐、嗜睡、瘙痒发生率低于其他三组（P〈0．05）。结论布托啡诺具有较好的镇痛效果、较轻的不良反应的优点，可安全有效地用于老年病人术后镇痛。Objective To compare the effects of patient-controlled intravenous analgesia with butorphanol, tramadol, meperidine, and bntorphanol combined meperidine on elderly patients. Methods A total of 120 elderly patients undergoing operation in belly and lower limbs were divided into four groups at random, i.e. Group B with butorphanol, Group T with tramadol, Group M with mepefidine and Group B ＋ M with butorphanol combined mepefidine. Loading dose （butorphanol 1 mg, tramadol 50 mg, mepefidine 50 mg, hutorphanol 0.5 and mepefidine 25 mg） was injected 10 - 30 minutes earlier before the operation was finished. Observation was conducted according to double-blinded principle. Visual ache simulation （VAS） score was used to evaluate the degree of analgesia. Results There were no significant differences in heart rate, blood pressure and breath frequency in all the patients at different time-points （ P 〉 0.05 ）. The VAS scores were significantly different in Group B and Group B ＋ M when compared to that of the other two groups at the time-poits of 6 and 12 hours （P 〈 0.05）. The incidence rates of nausea, vomiting, somnolence and itch was obviously lower in Group B than in the other three groups （ P 〈 0.05 ）. Conclusion Butorphanol has the forte of good analgesia effect and few untoward effects, and it can be safely applied to elderly patients for patient-controlled intravenous analgesia.

关 键 词：老年病人 术后镇痛 布托啡诺 曲马多 哌替啶 

分 类 号：R971.2[医药卫生—药品]