布托啡诺联合舒芬太尼术后静脉PCA用于腹腔镜胃癌根治术患者的效果  

Efficacy of intravenous PCA with butorphanol combined with sufentanil after laparoscopic radical gastrectomy

作　　者：杨艳妮[1] 刘亚涛[1] 高向梅[1] YANG Yanni;LIU Yatao;GAO Xiangmei(Department of Anesthesiology and Operating Theater,First Hospital,Lanzhou University,Lanzhou 730000,CHINA)

机构地区：[1]兰州大学第一医院麻醉手术科,甘肃730000

出　　处：《江苏医药》2022年第5期503-506,共4页Jiangsu Medical Journal

摘　　要：目的 观察不同剂量布托啡诺联合舒芬太尼术后静脉患者自控镇痛(PCA)用于腹腔镜胃癌根治术患者的效果。方法 行腹腔镜胃癌根治术的患者65例,术毕超声引导下双侧肋缘下腋中线水平腹横筋膜阻滞。术后实施静脉PCA,配方分别为布托啡诺0.1 mg/kg+舒芬太尼3μg/kg(A组,22例)、布托啡诺0.15 mg/kg+舒芬太尼3μg/kg(B组,22例)和布托啡诺0.2 mg/kg+舒芬太尼3μg/kg(C组,21例)。于术后出麻醉后恢复室(T1)、术后24 h(T2)、术后48 h(T3)和术后72 h(T4)时,评估患者VAS疼痛评分和Ramsay镇静评分,记录PCA按压次数、补救药双氯芬酸钠使用情况以及不良反应发生率。结果 T1~T4时,B、C组VAS疼痛评分低于A组(P<0.05)。C组T2时Ramsay镇静评分高于A、B组(P<0.05)。C组双氯芬酸钠用量少于A、B组(P<0.05)。C组术后头晕发生率高于A、B组(P<0.05)。结论 采用布托啡诺0.15 mg/kg联合舒芬太尼3μg/kg行静脉PCA,可减轻腹腔镜胃癌根治术患者术后疼痛。Objective To observe the efficacy of intravenous patient-controlled analgesia(PCA) with different dosages of butorphanol combined with sufentanil in the patients after laparoscopic radical gastrectomy.Methods Ultrasound-guided abdominal transverse fascia block on the midaxillary line of bilateral costal margin horizontal level was performed in 65 patients underwent laparoscopic radical gastrectomy, which was followed by intravenous PCA with butorphanol 0.1 mg/kg plus sufentanil 3 μg/kg(group A,22 cases),butorphanol 0.15 mg/kg plus sufentanil 3 μg/kg(group B,22 cases) or butorphanol 0.2 mg/kg plus sufentanil 3 μg/kg(group C,21 cases).The VAS pain score and Ramsay sedation score were evaluated at the time points of leaving postoperative anesthesia recovery room(T1),postoperative 24 hours(T2),48 hours(T3) and 72 hours(T4).The PCA number, remedial use of diclofenac sodium and incidence of adverse responses were recorded.ResultsThe VAS score at T1-T4 in groups of B and C was lower than that in group A(P<0.05).The Ramsay sedation score at T2 was higher in group C than that in groups of A and B(P<0.05).The dosage of diclofenac sodium was less in group C than that in groups of A and B(P<0.05).The incidence of dizziness was higher in group C than that in groups of A and B(P<0.05).ConclusionIntravenous PCA with butorphanol 0.15 mg/kg combined with sufentanil 3 μg/kg can alleviate the degree of pain after laparoscopic radical gastrectomy.

关 键 词：布托啡诺 舒芬太尼 胃癌根治术 患者自控镇痛 

分 类 号：R614[医药卫生—麻醉学]