酒石酸布托啡诺鼻喷剂用于经皮椎间孔镜手术镇痛与镇静效果观察  

Clinical Observation of the Analgesic and Sedative Effects of Butorphanol Tartrate Nasal Spray During the Perioperative Period of Percutaneous Transforaminal Endoscopic Discectomy

作　　者：吴从俊 李涛 张同会 李绪贵 谢维 唐谨 杨晶晶 WU Congjun;LI Tao;ZHANG Tonghui;LI Xugui;XIE Wei;TANG Jin;YANG Jingjing(Wuhan Orthopaedics Hospital of Integrated Traditional Chinese and Western Medicine·The Affiliated Hospital of Wuhan Sports University,Wuhan,Hubei,China 430079)

机构地区：[1]湖北省武汉中西医结合骨科医院·武汉体育学院附属医院,湖北武汉430079

出　　处：《中国药业》2025年第7期89-92,共4页China Pharmaceuticals

基　　金：湖北陈孝平科技发展基金会临床研究基金项目[CXPJJH12000005-07-10]。

摘　　要：目的比较酒石酸布托啡诺鼻喷剂与传统镇静方案用于经皮椎间孔镜(PTED)手术的有效性和安全性。方法选取医院2021年2月至2022年6月收治的侧入路局部麻醉(简称局麻)下行PTED手术的单节段腰椎间盘突出症(LDH)患者100例,按入院顺序分为传统镇静方案组(A组)和酒石酸布托啡诺鼻喷剂组(B组),各50例。A组患者予盐酸右美托咪定联合帕瑞昔布局麻方案,B组患者予酒石酸布托啡诺鼻喷剂局麻方案。结果与A组比较,B组患者术中30 min的视觉模拟评分法(VAS)评分相当(P>0.05),平均动脉压(MAP)、心率(HR)、Richmond躁动镇静评分量表(RASS)评分均显著更低(P<0.05),血清β-内啡肽(β-EP)水平和利克特量表(Likert)评分均显著更高(P<0.05)。B组患者的不良反应和并发症发生率分别为10.00%和0,显著低于A组的26.00%和8.00%(P<0.05)。结论酒石酸布托啡诺鼻喷剂用于局麻下行PTED手术单节段LDH患者的镇痛、镇静效果良好,能有效降低应激反应程度,提高患者满意度,维持术中血流动力学平稳,且镇静作用更平缓,不良反应和并发症少。Objective To compare the efficacy and safety of Butorphanol Tartrate Nasal Spray and traditional analgesic and sedative regimen during the perioperative period of percutaneous transforaminal endoscopic discectomy(PTED).Methods A total of 100 patients with single-segment lumbar disc herniation(LDH)who underwent PTED under local anesthesia admitted to the hospital from February 2021 to June 2022 were selected and divided into the traditional sedation group(group A)and the butorphanol tartrate nasal spray group(group B)according to the admission order,with 50 cases in each group.The patients in group A were given dexmedetomidine hydrochloride combined with parecoxib for anesthesia,while patients in group B were given Butorphanol Tartrate Nasal Spray for local anesthesia.Results Compared with those in group A,the visual analog scale(VAS)scores at 30 min during surgery in group B were comparable(P>0.05),the mean arterial pressure(MAP),heart rate(HR),and Richmond Agitation Sedation Scale(RASS)score in group B were significantly lower(P<0.05),and the serumβ-endorphin(β-EP)level and Likert scale score in group B were significantly higher(P<0.05).The incidence rates of adverse reactions and complications in group B were 10.00%and 0,which were significantly lower than 26.00%and 8.00%in group A(P<0.05).Conclusion Butorphanol Tartrate Nasal Spray has good analgesic and sedative effects in patients with single-segment lumbar disc herniation(LDH)undergoing PTED under local anesthesia.It can effectively reduce the degree of stress response,improve patients′satisfaction,maintain stable intraoperative hemodynamics,and has a smoother sedative effect with fewer adverse reactions and complications.

关 键 词：酒石酸布托啡诺鼻喷剂 经皮椎间孔镜手术 单节段腰椎间盘突出症 局部麻醉 麻醉效果 

分 类 号：R969.4[医药卫生—药理学] R971.2[医药卫生—药学]