布托非诺治疗丙泊酚注射痛的临床观察

目的：观察布托非诺治疗丙泊酚注射痛的效果。方法：选择ASAⅠ～Ⅱ级、年龄18～38岁、自愿接受无痛人流术的早孕妇女300例,随机分为0．9％氯化钠注射液组（N）组100例、2％利多卡因组（L）组100例和布托非诺组（B）组100例,均开放手背静脉,并于注射芬太尼和丙泊酚之前分别注射0．9％氯化钠注射液2ml、2％利多卡因2ml（40mg）和布托非诺1ml（1mg）,随即由专人观察注射丙泊酚时患者手背的疼痛程度及不良反应,疼痛程度采用视觉模拟（VAS）评分法,所有患者芬太尼用量均为1μg·kg^-1,丙泊酚用量以呼之不应、睫毛反射消失且无肢体运动时所给剂量计为实际有效剂量。结果：三组患者VAS评分：N组明显高于L组和B组（P〈0．01）,L组也高于B组（P〈0．01）。B组丙泊酚用量明显少于N组和L组（P〈0．05）。结论：布托非诺既能够解除丙泊酚注射时的手背痛,又避免了利多卡因过敏和中毒的高度危险性,且减少了丙泊酚的用量,是一种较安全、理想的无痛人流术前用药。     

舒芬太尼联合丙泊酚用于人工流产术临床观察

目的：观察舒芬太尼联合丙泊酚在人工流产术中的麻醉效果和不良反应。方法：自愿接受无痛人工流产手术的育龄妇女200例随机分为舒芬太尼组（S组,n：100）和芬太尼组（F组,n=100）,S组先静注舒芬太尼0．1μg·kg^-1,接着静注丙泊酚1．8mg·kg^-1;17组先静注芬太尼1μg·kg^-1,接着静注丙泊酚2．3mg·kg^-1,在患者意识丧失、呼之不应后开始手术。观察两组患者的麻醉诱导时间、丙泊酚用量、清醒时间,收缩压、舒张压、心率、呼吸变化及不良反应发生情况。结果：S组丙泊酚用量明显少于F组,不良反应发生率也明显低于F组（P〈0．01）。结论：舒芬太尼联合丙泊酚是较理想的无痛人流术的复合麻醉方法。     

布托非诺治疗硬膜外阻滞后寒战的临床观察

目的 观察布托非诺对硬膜外腔阻滞后寒战的治疗效果及不良反应.方法 将在硬膜外腔阻滞下行腹部手术的病人ASA Ⅰ～Ⅱ级100例随机分为两组,每组50例,布托非诺组(B组)经静脉注射0.04%布托非诺20μg/kg;哌替啶组(P组)经静脉注射1%哌替啶0.75 mg/kg.两组注药部位均为上肢静脉,注药速度均为30 ml/min,若注药5 min后寒战仍未消失者再经静脉加注咪达唑仑0.05 mg/kg.观察两组病人的治疗效果和不良反应.结果 两组病人一般情况(性别、年龄、身体指数)、手术部位、静脉给药部位及手术开始前输液速度差异均无统计学意义(P＞0.05),两组注药前寒战的分级与注药后1、5 min治疗效果的判定差异均无统计学意义(P＞0.05),但注药后3min治疗效果的判定B组优于P组(P＜0.05),而B组不良反应明显低于P组(P＜0.01).结论 布托非诺治疗硬膜外腔阻滞后寒战效果确切,不良反应少,优于哌替啶,是一种理想的治疗硬膜外阻滞后并发症寒战的药物.

Abstract：

Objective To observe the clilnical effect of treatment of chill by butorphanol after epidural anesthesthia. Methods One hundred patients under going epidural anesthesia , divided into two groups randomly, 50 in butorphanol group(B)were injected intravenously through upper limbs with 0. 04% butorphanol (diluted with normal saline)20 μg/kg; 50 in pethidine group(P) were injected intravenously through upper limbs with 1% pethidine ( diluted with normal saline )0. 75 mg/kg. The speed of the two injection was30 ml/min, after five minutes the patients who were still chilling were injected with midazolam 0. 05 mg/kg. Observe the effect and complications after one minute, three minutes and five minutes. Results After one minute and five minutes the effect of treating chill was no statistically difference ( P ＞ 0. 05 ).However, after three minutes the effect of the butorphanol group was obviously superior to the pethidine group ( P ＜0. 05) ,And the complications of butorphanol group was also less than pethidine group ( P ＜0. 01) . Conclusion Butorphanol display good effect on treating the chill after epidural anesthesia.