不同剂量酒石酸布托啡诺预防性镇痛对妇科腹腔镜手术术后疼痛的影响  

The effect of different doses of butorphanol tartrate prophylactic analgesia on postoperative pain in gynecological laparoscopic surgery

作　　者：张明杰 孙忠良[1] 孙德峰[1] Zhang Mingjie;Sun Zhongliang;Sun Defeng(Department of Anesthesiology,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China)

机构地区：[1]大连医科大学附属第一医院麻醉科,大连116011

出　　处：《中国医师杂志》2023年第11期1630-1634,1639,共6页Journal of Chinese Physician

摘　　要：目的观察预注射三种不同剂量酒石酸布托啡诺对妇科腹腔镜手术术后疼痛的影响。方法前瞻性选取2022年4月至12月于大连医科大学附属第一医院择期行全麻下妇科腹腔镜手术的患者172例,按随机数字表法将患者分为B1、B2、B3三组,分别于术前15 min予以10、20、30μg/kg酒石酸布托啡诺组。记录患者给药后10 min时的Ramsay镇静评分;术后2、6、12、24、48 h静息状态及活动状态的疼痛数字评估量表(NRS)评分,舒适度评分(BCS);术中不同时点的血流动力学参数;术后辅助镇痛药物使用情况、患者自控静脉镇痛(PCIA)有效按压次数;术后不良反应发生率。结果三组患者一般特征比较差异无统计学意义(均P>0.05)。给药后10 min时,B2组、B3组的Ramsay评分与B1组差异有统计学意义(均P<0.05)。术后12、24 h,B3组静息状态NRS评分小于B2组、B1组,B2组小于B1组(均P<0.05);术后6、12、24 h,B2组、B3组术后活动状态NRS评分小于B1组(均P<0.05);术后6、12 h,B3组活动状态NRS评分小于B2组(均P<0.05)。术后6、24 h,B2组、B3组BCS与B1组差异有统计学意义(均P<0.05)。三组患者术中各时点的血流动力学参数、术后48 h内的PCIA有效按压次数、术后不良反应发生率比较差异无统计学意义(P>0.05)。三组术后追加镇痛药物率比较差异有统计学意义(均P<0.05)。结论妇科腹腔镜手术术前15 min静脉注射30μg/kg酒石酸布托啡诺预防性镇痛可达到较好的镇痛作用,不良反应较少,可作为妇科腹腔镜手术预防性镇痛的优先剂量。Objective To observe the effect of pre injection of three different doses of butorphanol tartrate on postoperative pain in gynecological laparoscopic surgery.Methods A prospective study was conducted on 172 patients who underwent gynecological laparoscopic surgery under general anesthesia at the First Affiliated Hospital of Dalian Medical University from April to December 2022.According to the random number table method,patients were divided into B1 group,B2 group,and B3 group.These three groups were given 10,20,and 30μg/kg butorphanol tartrate 15 minutes before surgery,respectively.Ramsay sedation score at 10 minutes after patient administration,the pain Numerical Rating Scale(NRS)scores and Bruggrmann Comfort Scale(BCS)for resting and active states at 2,6,12,24,and 48 hours after surgery,hemodynamic parameters at different time points during surgery,postoperative use of adjuvant analgesics and effective number of compressions for patient-controlled intravenous analgesia(PCIA)and the incidence of postoperative adverse reactions were recorded.Resultsl There was no statistically significant difference in general characteristics among the three groups of patients(all P>0.05).At 10 minutes after administration,there was a statistically significant difference in Ramsay scores between groups B2 and B3 compared to group B1(all P<0.05).At 12 and 24 hours after surgery,the resting NRS score of B3 group was lower than that of B2 group and B1 group,and B2 group was lower than B1 group(all P<0.05);At 6,12,and 24 hours after surgery,the NRS scores of postoperative activity in the B2 and B3 groups were lower than those in the B1 group(all P<0.05);At 6 and 12 hours after surgery,the NRS score of the B3 group was lower than that of the B2 group(all P<0.05).At 6 and 24 hours after surgery,there was a statistically significant difference in BCS between groups B2 and B3 compared to group B1(all P<0.05).There was no statistically significant difference in the hemodynamic parameters at each time point during surgery,the effective n

关 键 词：妇科外科手术 腹腔镜检查 疼痛 手术后 布托啡诺 镇痛 

分 类 号：R614[医药卫生—麻醉学]