布托啡诺对宫腔镜手术患者的镇痛效果分析  

Analysis of the analgesic effect of butorphanol on patients undergoing hysteroscopic surgeries

作　　者：黄伟格 雷华娟[1] HUANG Weige;LEI Huajuan(Department of Anesthesiology and Surgery,the First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,China)

机构地区：[1]湖南中医药大学第一附属医院麻醉手术科,长沙410007

出　　处：《长春中医药大学学报》2022年第10期1148-1151,共4页Journal of Changchun University of Chinese Medicine

基　　金：湖南省卫生计生委科研计划课题横向项目(B20180637)。

摘　　要：目的分析布托啡诺对宫腔镜手术患者的镇痛效果。方法选择进行宫腔镜手术患者100例,采用随机数表法分为芬太尼组与布托啡诺组,各50例。2组均进行血浆靶浓度靶控输注丙泊酚,在此基础上,芬太尼组采用芬太尼进行镇痛,布托啡诺组采用布托啡诺进行镇痛,2组术后均观察24 h。统计2组麻醉、手术情况及观察期间不良反应发生情况,比较2组T0、T1、T2时间点生命体征及T1、T2时间点脑电意识指数(IOC_(1))和伤害意识指数(IOC_(2))。结果布托啡诺组最终靶控输注丙泊酚满足手术无体动的有效血浆靶浓度低于芬太尼组(P<0.05)。T1、T2时间点,2组平均动脉压(MAP)、氧分压(SpO_(2))均低于T0时间点,呼气末二氧化碳分压(P_(ET)CO_(2))高于T0时间点(P<0.05),组间比较,差异均无统计学意义(P>0.05);T1、T2时间点,芬太尼组心率(HR)低于T0时间点,T1时间点,布托啡诺组HR高于芬太尼组(P<0.05)。T1、T2时间点,布托啡诺组、芬太尼组IOC_(1)、IOC_(2)组内比较和组间比较,差异均无统计学意义(P>0.05)。观察期间,布托啡诺组呼吸抑制、术后疼痛发生率分别为4.00%、2.00%,均显著低于芬太尼的18.00%、14.00%(P<0.05)。结论与芬太尼比较,采用布托啡诺对宫腔镜手术患者进行镇痛,可有效降低患者最终靶控输注丙泊酚满足手术无体动的有效血浆靶浓度,维持患者术中生命体征,降低患者术后呼吸抑制和疼痛发生,具有较好的镇痛效果。Objective To analyze the analgesic effects of butorphanol on patients undergoing hysteroscopic surgeries.Methods A total of 100 patients undergoing a hysteroscopic surgery were selected as the study subjects and divided into a fentanyl group and a butorphanol group by the random number table method,with 50 cases in each group.Propofol was administered to both groups by the plasma target concentration target controlled infusion,and fentanyl was used for analgesia in the fentanyl group while butorphanol in the butorphanol group.Both groups were observed for 24 h after surgery.The conditions of anesthesia and surgery and the incidence of adverse reactions during observation were analyzed.The vital signs at time points after entry(T0),anesthesia(T1)and endometrial curetting(T2),and the electroencephalogram consciousness index(IOC_(1))and injury consciousness index(IOC_(2))at time points T1 and T2 were compared between the two groups.Results In the butorphanol group,the effective plasma target concentration of the final target-controlled infusion of propofol to satisfy the surgery without body movement was lower than that of the fentanyl group(P<0.05).At T1 and T2,the mean arterial pressure(MAP)and partial oxygen pressure(SpO_(2))in the two groups were lower than those at T0,while the partial pressure of end-expiratory carbon dioxide(P_(ET)CO_(2))was higher than that at T0(P<0.05).There was no statistical significance between the two groups(P>0.05).At T1 and T2,the heart rate(HR)of the fentanyl group was lower than that of the T0,while the HR of the butorphanol group was higher than that of the fentanyl group at T1(P<0.05).At T1 and T2,there were no significant differences in IOC1 and IOC2 between the butorphanol group and the fentanyl group(P>0.05).During the observation period,the incidence of respiratory depression and postoperative pain in the butorphanol group was 4.00% and 2.00%,respectively,which were significantly lower than the fentanyl group(18.00% and 14.00%,P<0.05).Conclusion Compared with fentanyl,the ana

关 键 词：宫腔镜 布托啡诺 芬太尼 镇痛 生命体征 

分 类 号：R614.2[医药卫生—麻醉学]