丁丙诺啡透皮贴联合复方亚甲蓝注射液用于肛肠手术术后镇痛的效果  

Effect of buprenorphine transdermal patch combined with methylene blue injection on analgesia after anorectal surgery

作　　者：曹秋锐 魏保沛 谭英娣 黄志芳 郭金彦 CAO Qiugrui;WEIBaopei;TAN Yingdi;HUANG Zhifang;GUO Jinyan(Anorectal Department,Jiangmen Wuyi Hospital of Traditional Chinese Medicine,Jiangmen,Guangdong 529000,China)

机构地区：[1]广东省江门市五邑中医院肛肠科

出　　处：《中国医学工程》2019年第4期41-44,共4页China Medical Engineering

基　　金：肛周带状皮瓣推移术治疗陈旧性肛裂的临床研究(2017A2058)

摘　　要：目的研究丁丙诺啡透皮贴联合复方亚甲蓝注射液用于肛肠手术术后镇痛的效果。方法选取2017年1月‐2018年8月于该院择期行肛肠手术的患者160例,随机将其分为研究组(80例)及对照组(80例)。对照组术后肛周注射1%复方亚甲蓝2 ml+罗哌卡因10 ml+注射用水5 ml混合液,在此基础上,研究组加用丁丙诺啡透皮贴剂。观察两组不同时间点疼痛评分、镇静评分,同时比较两组应激激素水平及不良反应发生情况。结果研究组术后6、12及24 h的视觉模拟法(VAS)评分均低于对照组,差异有统计学意义(P<0.05),而两组Ramsay镇静评分差异无统计学意义(P>0.05);研究组术后24 h的超敏C反应蛋白(hs-CRP)、血浆皮质醇(COR)、肿瘤坏死因子-α(TNF-α)水平均明显低于对照组(P<0.05);此外,两组不良反应发生情况相仿,组间差异无统计学意义(P>0.05)。结论丁丙诺啡透皮贴联合复方亚甲蓝注射液对肛肠手术患者术后镇痛有良好效果,可明显改善患者术后应激反应,且安全性较佳,值得临床推荐。【Objective】 To study the effect of buprenorphine transdermal patch combined with methylene blue injection on analgesia after anorectal surgery.【Methods】A total of 160 patients who underwent elective anorectal surgery in our hospital from January 2017 to August 2018 were randomly divided into study group (80 cases) and control group (80 cases). In the control group, 2 ml 1% methylene blue + 10 ml ropivacaine + 5 ml water for injection was injected into the perianal area. On the basis of this, the study group was given a transdermal patch of buprenorphine. Pain scores and sedation scores were observed at different time points in the two groups. The levels of stress hormones and adverse reactions were compared between the two groups.【Results】 The VAS scores of the observation group at 6 h, 12 h, and 24h after operation were lower than those of the control group (P<0.05), but the Ramsay sedation scores of the two groups were not significantly different (P>0.05). The levels of hs-CRP, COR and TNP-α 24 hours after surgery of the observation group were significantly lower than those of the control group (P <0.05). In addition, the incidence of adverse reactions was similar in the two groups, and there was no significant difference between the two groups (P>0.05).【Conclusion】 The combination of buprenorphine transdermal patch with methylene blue injection has a good effect on postoperative analgesia in patients with anorectal surgery, it can significantly improve the postoperative stress response, and is worthy of clinical recommendation with good safety.

关 键 词：肛肠手术 术后镇痛 丁丙诺啡透皮贴 复方亚甲蓝注射液 

分 类 号：R619[医药卫生—外科学]