羟考酮复合布托啡诺用于二次剖宫产术后静脉自控镇痛的效果  

Efficacy of oxycodone combined with butorphanol for patient-controlled intravenous analgesia after secondary cesarean section.

作　　者：钱夏丽 朱伟[1] 韩传宝[1] QIAN Xiali;ZHU Wei;HAN Chuanbao(Department of Anesthesiology,First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China)

机构地区：[1]南京医科大学第一附属医院麻醉科

出　　处：《临床麻醉学杂志》2019年第5期444-447,共4页Journal of Clinical Anesthesiology

摘　　要：目的评估羟考酮复合布托啡诺用于二次剖宫产术后静脉自控镇痛的效果。方法选择择期硬膜外麻醉下行二次剖宫产产妇60例,年龄25~40岁,孕周37~40周,体重65~85 kg,ASAⅠ或Ⅱ级。按随机数字表分为两组:羟考酮复合布托啡诺组(OB组)和布托啡诺组(B组),每组各30例。胎儿娩出后,OB组静脉缓慢注射0.1 mg/kg羟考酮注射液,B组静脉缓慢注射0.02 mg/kg布托啡诺注射液,关腹时连接静脉自控镇痛泵。记录产妇术后2、4、8、12、24 h切口痛以及宫缩痛的VAS疼痛评分;评估术后镇痛满意度;记录术后24 h内PCIA按压次数,初乳时间及0~4 h、4~12 h和12~24 h各时间段哺乳次数;记录恶心呕吐、皮肤瘙痒、头晕、嗜睡、呼吸抑制等不良反应的发生情况。结果与B组比较,术后2、4、8、12、24 h OB组切口痛以及宫缩痛的VAS评分明显降低(P<0.05),镇痛期间PCIA按压次数明显减少(P<0.05);OB组镇痛满意度2分的产妇比例明显少于B组,OB组镇痛满意度4分的产妇比例明显多于B组(P<0.05);OB组术后初乳时间明显早于B组(P<0.05)。两组恶心呕吐、头晕、嗜睡等术后不良反应的发生情况差异无统计学意义。结论羟考酮复合布托啡诺用于二次剖宫产术后静脉自控镇痛效果好,产妇满意度高,不良反应发生少,并可促进产后早期泌乳。Objective To evaluate the efficacy of oxycodone combined with butorphanol for patient-controlled intravenous analgesia after secondary cesarean section. Methods Sixty multiparae,aged 25-40 years, gestational aged 37-40 weeks, weighing 65-85 kg, falling into ASA physical status Ⅰ or Ⅱ, scheduled for second cesarean section, were randomly divided into two groups(n = 30 each) according to the random number table: oxycodone+butorphanol group(group OB) and butorphanol group(group B). The patients in the group OB received an intravenous dose of 0.1 mg/kg oxycodone hydrochloride, while the patients in the group B received an intravenous dose of 0.02 mg/kg butorphanol tartrate after delivery of the fetus. After abdominal was closed, the intravenously controlled analgesia pump was connected to the patients in both groups. The VAS score of uterine cramping pain and incision pain were recorded at 2, 4, 8, 12 and 24 h after the surgery. Patient’s satisfaction was assessed at the end of 24 h. The number of PCIA pressing times within 24 h after surgery, colostrum time, lactation times of 0-4 h,4-12 h,12-24 h, and occurrence of postoperative adverse reactions such as nausea and vomiting, skin itching, dizziness, sleepiness and respiratory depression were recorded. Results At all time points(2, 4, 8, 12 and 24 h after surgery), VAS of uterine cramping pain and incision pain in group OB were significantly lower than those in group B(P<0.05). The number of PCIA boluses in group OB were significantly lower than those in group B(P<0.05).The satisfaction degree of analgesia in group OB was significantly better than that in group B(P<0.05). The colostrum time of group OB was significantly earlier than that in group B(P<0.05). There was no significant statistic difference in the occurrence of adverse reactions such as nausea and vomiting, dizziness and sleepiness between the two groups. Conclusion The oxycodone combined with butorphanol tartrate patient-controlled intravenous analgesia not only has better analgesic effect, higher

关 键 词：羟考酮 布托啡诺 二次剖宫产术 镇痛 

分 类 号：R614[医药卫生—麻醉学] R719.8[医药卫生—外科学]