布托啡诺联合罗哌卡因用于下肢骨折术后硬膜外镇痛的临床观察  

Clinical observation of butorphanol combined with ropivacaine in epidural analgesia after lower limb fracture

作　　者：陈勇[1] 罗燕[1] 董理[1] 杨帅[1] 邓磊[1] 

机构地区：[1]成都大学附属医院麻醉科,成都市610081

出　　处：《临床合理用药杂志》2011年第19期29-30,共2页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察布托啡诺联合罗哌卡因用于下肢骨折术后患者连续硬膜外自控镇痛(PCEA)的镇痛效果,为临床提供参考。方法将60例ASAⅠ～Ⅱ级且拟在腰硬联合麻醉下行下肢骨折内固定术患者,根椐术后镇痛方式不同随机分为2组,每组30例:Ⅰ组予布托啡诺6mg+罗哌卡因75mg;Ⅱ组予罗哌卡因225mg+芬太尼0.4mg,每组均用0.9%生理盐水稀释到200ml,背景剂量3ml/h,自控镇痛(PCA)2ml,锁定时间15min。术后观察4、12、24和48h的平均动脉压(MAP)、心率(HR)、脉搏氧饱和度(SpO2)、患者平静时的视觉模拟(VAS)疼痛评分及Ramsay评分法评估镇静程度,统计不良反应并在镇痛结束后统计患者对镇痛治疗的总体满意度。结果 2组术后各时间点MAP、HR及SpO2组间差异无统计学意义(P>0.05)。2组术后各时段VAS评分及Ramsay评分差异无统计学意义(P>0.05)。Ⅰ组患者术后不良反应总发生率为6.7%低于Ⅱ组的16.7%(P<0.05);Ⅰ组镇痛治疗总体满意率高于Ⅱ组(P<0.05)。结论布托啡诺联合罗哌卡因用于下肢骨折术后PCEA镇痛效果佳,不良反应少,患者术后总体满意率高,可作为临床PCEA的一种较佳选择。Objective To observe the analgesic effect of butorphanol combined with ropivacaine in PCEA after lower limb fracture.Methods 60 cases patients with ASAⅠ~Ⅱ fitting downstream joint anesthesia in waist hard extremities fractures fixation,postoperative analgesia randomly divided into two groups,each of 30 cases：I group were given butorphanol 6mg＋ropivacaine 75mg;Ⅱ group were given ropivacaine 225mg＋fentanyl 0.4mg,each group were used 0.9% saline dilution to 200ml,background dose 3ml/h,patient-controlled analgesia（PCA） 2ml,lock time 15min.Observed postoperative 4,12,24 and 48h＇s mean arterial pressure（MAP）,heart rate（HR）,pulse oximetric saturation（SpO2）,the visual simulation when person calm（VAS） pain score and evaluation calm degree used Ramsay pointrating method,adverse reaction and overall satisfaction degree with analgesia.Results The MAP,HR and SpO2 of 2 groups at all time points were no significant difference（P〈0.05）.Postoperative VAS score and the Ramsay score of two groups were no significant difference（P〉0.05）.Total incidence of adverse reactions of Ⅰ group（6.7%） was lower than that of Ⅱ group（16.7%）（P〈0.05）;The overall satisfaction with analgesia of Ⅰ group was higher than that of Ⅱ group（P〈0.05）.Conclusion Butorphanol combined with ropivacaine in PCEA after lower limb fracture has nice effect,fewer adverse reaction,the postoperative overall satisfaction rate high,can be used as a better choice in PCEA.

关 键 词：布托啡诺 罗哌卡因 硬膜外镇痛 自控镇痛 

分 类 号：R614.42[医药卫生—麻醉学]