比较布托啡诺、芬太尼及芬太尼联合曲马多用于老年患者术后镇痛的临床效果

目的研究布托啡诺用于老年患者术后静脉镇痛的疗效及不良反应。方法60例择期行上腹部手术的老年患者,随机均分为布托啡诺组(B组)、芬太尼组(F组)及芬太尼联合曲马多组(FT组),分别接受持续静脉镇痛。记录并比较术后48h内疼痛视觉模拟评分(VAS)、Ramsay镇静评分及不良反应。结果三组术后镇痛效果VAS组内比较差异无统计学意义。但术后6hF组和B组的VAS明显低于FT组(P<0.05);术后12h,B组的VAS仍低于FT组(P<0.05)。B组术后0.5、6、12h Ramsay镇静评分明显高于F组(P<0.05)。B组恶心呕吐发生率明显低于FT组(P<0.05)。结论布托啡诺可用于老年患者术后静脉镇痛。

Efficiency of postoperative analgesia with butorphanol in elder patients

Objective To study the efficiency and side effects of postoperative analgesia with butorphanol in elder patients. Methods Sixty elder patients undergoing selective upper abdominal operations,were randomly assigned into 3 groups with 20 cases each.For postoperative intravenous analgesia,butorphanol 0.125mg/kg was given in group B,fentanyl 0.016mg/kg in group F and fentanyl 0.008mg/kg combined with Tramadol 6.25mg/kg in group FT. The visual analogue scale (VAS) analgesic score,Ramesy sedative score and side effects were recorded and compaered among three groups within 48h after the operations. Results There were no significant differences in VAS scores among 3 groups. VAS scores of group F and group B were much lower than those of group FT at 6h after operation (P<0.05). VAS score of group B was still lower than that of group FT at 12h after operations(P<0.05). Ramesy score of group B was significantly higher than that of group F at 0.5,6 and 12h after operation(P<0.05).The incidence of postoperation nausea and vomiting (PONV)of group B was significurtly lower than that of group FT (P<0.05). Conclusion Postoperative intravenous analgesia with butorphanol can be used effectively and safeltysafe in elder patients undergoing upper abdominal operations.