布托啡诺超前镇痛用于改良悬雍垂腭咽成形术患者术后镇痛的观察

目的观察布托啡诺超前镇痛用于改良悬雍垂腭咽成形术患者术后镇痛的效果。方法选择阻塞性睡眠呼吸暂停低通气综合症在全麻下行改良悬雍垂腭咽成形术且麻醉效果确切的患者94例,随机均分为布托啡诺组(A组)、对照组(B组)。A组于麻醉诱导前5min缓慢静注布托啡诺2mg(用生理盐水稀释至5mL);B组以生理盐水5mL缓慢静注。分别于术后1、4、8、12、20、24h进行镇痛及舒适度评分,观察并记录两组患者术后镇痛中恶心、呕吐、皮肤瘙痒、呼吸抑制、头晕、尿潴留等不良反应。结果 A组除术后1h其它各时间点疼痛评分明显低于B组(P<0.05),舒适度评分明显高于B组(P<0.05)。恶心、呕吐的发生率A、B两组分别为8.5%和19.1%,A组显著低于B组(P<0.01),头晕、呼吸抑制等并发症的的发生率两组未见显著性差异。结论布托啡诺超前镇痛可安全、有效地应用于改良雍垂腭咽成形术的患者术后急性疼痛且副作用少。

Effect of Butorphanol Preemptive Analgesia for Postoperative Analgesia After Han-uvulopharyngoplasty

Objective To study the effect of butorphanol preemptive analgesia for postoperative analgesia after Han-uvulopalatopharyngoplasty（H-UPPP）.Methods Ninety-four obstructive sleep apnea hypopnea syndrome（OSAHS） patients selected for H-UPPP with the exact and effective general anesthesia were divided randomly and averagely into the butorphanol group（Group A） and the control group（Group B）.In Group A,at 5 min before induction of anesthesia,butorphanol 2 mg（diluted with saline to 5mL） were injected into vein slowly;and in Group B,5 mL normal saline were injected into vein slowly.Analgesia and comfort scores were respectively calculated at 1,4,8,12,20 and 24 h after operation,and adverse reactions such as nausea and vomiting,itchy skin,respiratory depression,dizziness and urinary retention et al during postoperative analgesia were observed and recorded in two groups.Results Postoperative pain scores at each time point except 1h after operation in Group A were significantly lower than in Group B（P0.05）,and comfort scores were significantly higer than in Group B（P0.05）.The incidence of nausea and vomiting in GroupAand B was respectively 8.5% and 19.1%（P0.01）,and adverse reactions such as itchy skin,respiratory depression,dizziness and urinary retention et al during postoperative analgesia were not significantly different.Conclusion Butorphanol preemptive analgesia can be safely and effectively used in Han-uvulopalatopharyngoplasty for the patients with postoperative acute pain and few side effects.