布托啡诺硬膜外隙不同给药方式对高龄患者术后镇痛效果的影响  

Effect of different ways of administrating butorphanol for elderly patients on epidural postoperative analgesia

作　　者：孙德峰[1] 杨林[2] 魏燚[1] 刘若传[1] 王丽杰[1] 韩俊[1] 

机构地区：[1]大连医科大学附属第一医院麻醉科,辽宁大连116011 [2]大连医科大学附属第一医院脑电图室,辽宁大连116011

出　　处：《中国现代医学杂志》2013年第13期92-94,共3页China Journal of Modern Medicine

摘　　要：目的观察不同时机硬膜外隙使用布托啡诺对高龄患者术后镇痛效果的影响。方法选择在硬膜外麻醉下行单侧人工全髋关节置换术且麻醉效果确切的的高龄患者86例,随机均分为A、B两组。A组在麻醉平面出现后,1%罗哌卡因5-7 mL注入硬膜外隙前,布托啡诺1 mg注入硬膜外隙。B组在术毕将布托啡诺1 mg注入硬膜外隙。观察并记录两组患者术后镇痛持续时间、术后镇痛中恶心、呕吐、皮肤瘙痒、呼吸抑制、头晕及尿潴留等不良反应。分别于术后4、8、12、20、24、30、36和48 h进行镇痛及舒适度评分。结果 A组术后综合镇痛质量明显优于B组,镇痛时间长于B组,头晕的发生率显著低于B组(P<0.05)。结论小剂量布托啡诺对高龄患者术后镇痛效果硬膜外隙预注方式优于术毕硬膜外给药,且副作用少。【Objective】 To study the effect of different ways of administrating butorphanol to elderly patients on epidural postoperative analgesia.【Methods】 Eighty-six elderly patients of unilateral total hip arthroplasty with the exact effective epidural anesthesia were divided randomly and averagely into Group A and Group B： in group A,1 mg butorphanol was injected into epidural space for postoperative analgesia after blocking level appearance and before 5～7 mL 1% ropivacaine were injected into epidural space;and in group B 1 mg butorphanol was injected into epidural space at the end of the operation.Postoperative analgesia duration,adverse reactions such as nausea and vomiting,itchy skin,respiratory depression,dizziness and urinary retention and so on during postoperative analgesia were observed and recorded in two groups,and analgesia and comfort scores were respectively calculated at 4,8,12,20,24,30,36 and 48 h after operation.【Results】 The comprehensive quality of postoperative analgesia in group A was better than in group B,and the analgesia duration was longer than in group B（P ＆lt;0.05）.The incidence of dizziness in group A was significantly lower than in group B（P ＆lt;0.05）.【Conclusions】 The postoperative analgesic effect with small dose of butorphanol by the epidural space pre-note way was better than surgery epidural administration for elderly patients and the side effects were less.

关 键 词：硬膜外麻醉 布托啡诺 术后镇痛 高龄患者 副作用 

分 类 号：R614.3[医药卫生—麻醉学]