不同剂量盐酸丁丙诺啡应用于术后患者硬膜外自控镇痛效果  

Effect of different dose of buprenorphine hydrochloride in patient-controlled epidural analgesia after operation

作　　者：刘涛 

机构地区：[1]高阳县医院麻醉科,河北高阳071500

出　　处：《新乡医学院学报》2014年第6期464-466,共3页Journal of Xinxiang Medical University

摘　　要：目的观察不同剂量盐酸丁丙诺啡应用于术后患者硬膜外自控镇痛(PCEA)的效果和不良反应。方法选择硬膜外麻醉择期手术患者152例,术后给予盐酸丁丙诺啡PCEA,根据盐酸丁丙诺啡的剂量不同分为Ⅰ组(26例)、Ⅱ组(38例)、Ⅲ组(26例)、Ⅳ组(26例)和Ⅴ组(26例),术后监测患者的血压、呼吸频率、心率及血氧饱和度,评估镇痛效果,观察并记录患者不良反应。结果 PCEA后5组患者血压、心率、呼吸频率及血氧饱和度比较差异均无统计学意义(P>0.05)。Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ组患者镇痛优良率分别为50.0%、100.0%、100.0%、96.2%、100.0%,Ⅰ组患者镇痛优良率显著低于Ⅱ、Ⅲ、Ⅳ、Ⅴ组,差异均有统计学意义(P<0.01);Ⅱ、Ⅲ、Ⅳ、Ⅴ组患者镇痛优良率比较差异均无统计学意义(P>0.05)。Ⅰ、Ⅱ、Ⅲ组患者恶心呕吐发生率比较差异均无统计学意义(P>0.05);Ⅳ、Ⅴ组患者恶心呕吐发生率比较差异无统计学意义(P>0.05);Ⅳ、Ⅴ组患者恶心呕吐发生率显著高于Ⅰ、Ⅱ、Ⅲ组,差异均有统计学意义(P<0.05)。Ⅰ、Ⅱ组患者尿潴留发生率比较差异无统计学意义(P>0.05);Ⅲ、Ⅳ、Ⅴ组患者尿潴留发生率显著高于Ⅰ、Ⅱ组,差异均有统计学意义(P<0.05)。仅Ⅱ组1例患者出现皮肤瘙痒;5组患者均未发生明显呼吸抑制。结论应用容量100 mL、流速为2 mL·h-1的镇痛泵进行盐酸丁丙诺啡PCEA,以0.45 mg剂量镇痛效果最佳,且患者不良反应轻。Objective To observe the effect and adverse reaction of different dose of buprenorphine hydrochloride in patient-controlled epidural analgesia（ PCEA） after operation. Methods A total of 152 patients who underwent selective operation under epidural anesthesia were selected. The patients received PCEA with buprenorphin hydrochloride after operation. All of the patients were divided into groupⅠ（ n = 26）,Ⅱ（ n = 38）,Ⅲ（ n = 26）,Ⅳ（ n = 26） and Ⅴ（ n = 26） according to different dose of buprenorphin hydrochloride. The blood pressure,respiration rate,heart rate and saturation of blood oxygen were monitored after operation. Anaesthetic effect was evaluated,and the adverse reaction of patients was observed. Results There was no significant difference in blood pressure,respiration rate,heart rate and saturation of blood oxygen among the five groups after PCEA（ P 0. 05）. The excellent rate of analgesia in group Ⅰ,Ⅱ,Ⅲ,Ⅳ and Ⅴ was 50. 0%,100. 0%,100. 0%,96. 2% and 100. 0% respectively. The excellent rate of analgesia in group Ⅰ was significantly lower than that in group Ⅱ,Ⅲ,Ⅳ and Ⅴ（ P 0. 01）. But there was no significant difference in the excellent rate of analgesia among group Ⅱ,Ⅲ,Ⅳ and Ⅴ（ P 0. 05）. There was no significant difference in nausea and vomiting rate among group Ⅰ,Ⅱ and Ⅲ（ P 0. 05）. There was no significant difference in nausea and vomiting rate between group Ⅳ and Ⅴ（ P 0. 05）. The nausea and vomiting rate in group Ⅳ and Ⅴ was significantly higher than that in group Ⅰ,Ⅱ and Ⅲ（ P 0. 05）. There was no significant difference in urinary retention rate between group Ⅰ and Ⅱ（ P 0. 05）. The urinary retention rate in group Ⅲ,Ⅳ and Ⅴ was significantly higher than that in group Ⅰ and Ⅱ（ P 0. 05）. Only one patient in group Ⅱ had itch of skin. All of patients in the five groups had no obvious respiratory depression. Conclusion The best dose of buprenorphin hydrochloride is 0. 45 mg in PCEA by analges

关 键 词：盐酸丁丙诺啡 硬膜外阻滞麻醉 术后镇痛 不良反应 

分 类 号：R614[医药卫生—麻醉学]