布托啡诺鼻喷剂用于腹腔镜胆囊切除术预防性镇痛的临床研究  

Effect of butorphanol nasal spray on preventive analgesia after laparoscopic cholecystectomy

作　　者：王玲 李美玲 朱宇 WANG Ling;LI Mei-ling;ZHU Yu(Department of Anesthesiology,Wuwei Hospital of Traditional Chinese Medicine,Wuwei,Anhui 238300,China)

机构地区：[1]无为市中医医院麻醉科,安徽无为238300

出　　处：《医药论坛杂志》2023年第4期73-77,共5页Journal of Medical Forum

摘　　要：目的 研究布托啡诺鼻喷剂在腹腔镜胆囊切除术中预防性镇痛的效果。方法 选取2021年5月—2022年2月在无为市中医医院行腹腔镜胆囊切除术择期患者90例,ASA分级Ⅰ~Ⅱ级,随机分为观察组(术前1mg布托啡诺鼻喷)和对照组,其中每组各45例。常规全麻诱导,比较两组术后2 h, 4 h, 8 h和24 h的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2))、VAS评分、BCS评分、Ramsay评分、术后胃肠功能恢复情况和不良反应发生率。结果 术后2 h观察组患者的HR较对照组减慢,MAP较对照组明显下降(P<0.05);两组各时点的SpO_(2)无统计学差异。两组术后2 h VAS评分、BCS评分和Ramsay评分差异有统计学意义(P<0.05),术后4 h VAS评分有统计学差异(P<0.05),术后8h BCS评分差异有统计学意义(P<0.05),术后24 h VAS评分比较差异有统计学意义(P<0.05)。术后观察组肠鸣音恢复时间、排气时间和首次下床时间均短于对照组,差异有统计学意义(P<0.05)。两组患者的不良反应发生率无统计学差异。结论 布托啡诺鼻喷剂可安全地应用于腹腔镜胆囊切除术的预防性镇痛,镇痛效果确切,且不良反应较少,具有减少术后躁动,减少患者术后恢复时间,适宜在临床麻醉领域推广应用。Objective To investigate the effect of butorphanol nasal spray on preventive analgesia after laparoscopic cholecystectomy. Methods A total of 90 patients who underwent laparoscopic cholecystectomy in Wuwei traditional Chinese medicine hospital from May 2021 to February 2022 were selected, Patients were randomly divided into observation group(preoperative nasal spray of butorphanol 1mg) and control group, There were 45 cases in each group.HR,MAP,SPO_(2),VAS score, BCS score and Ramsay score were recorded at 2h, 4h, 8h and 24h after under conventional general anesthesia.The recovery of gastrointestinal function and the incidence of adverse reactions were also recorded. Results 2 h after operation, HR in observation group was slower than that in cotrol group, and MAP in observation group was significantly lower than that in cotrol group(P<0.05);There was no significant difference in SpO_(2)between the two groups at each time point.There were statistically significant differences in postoperative 2hVAS score, BCS score and Ramsay score between observation group and cotrol group(P<0.05).There was statistically significant difference between N group and C group in postoperative 4hVAS score(P<0.05). There was statistically significant difference between observation group and cotrol group in postoperative 8hBCS scores(P<0.05). The 24hVAS score in observation group and cotrol group showed statistically significant difference(P<0.05). The recovery time of bowel sounds, exhaust time and out of bed activity time in observation group were shorter than those in cotrol group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups.Conclusions Butorphanol nasal spray can be used for preventive analgesia in laparoscopic cholecystectomy with definite effect and fewer adverse reactions.

关 键 词：布托啡诺 鼻喷剂 预防性镇痛 胆囊腹腔镜 

分 类 号：R614[医药卫生—麻醉学]