布托啡诺预防瑞芬太尼麻醉后痛觉过敏的临床研究

目的通过对布托啡诺对利用瑞芬太尼进行麻醉的患者苏醒后痛觉过敏的研究，对布托啡诺的镇痛效果和安全性进行评定。方法选择瑞芬太尼麻醉后进行腹腔镜下胆囊切除手术的患者60例，ASA分级为Ⅰ～Ⅱ级，全部患者随机分为两组，实验组：静脉注射布托啡诺30μg／kg；对照组：静脉注射0．9％NaCl溶液。观察两组患者的手术时间、睁眼时间以及拔管时间，比较两组布托啡诺诱导之前（T1）、患者苏醒时（T2）、患者苏醒后1h（T3）、患者苏醒后6h（T4）的VAS评分、Ramsay评分、收缩压（SBP）、舒张压（DBP）、心率（HR）、血氧饱和度（SpO2）、呼吸抑制的发生率等。结果（1）两组患者手术时间、睁眼时间以及拔管时间差异无统计学意义；（2）在T2、T3时，实验组Ramsay评分优于对照组，T4时，实验组Ramsay评分和VAS评分均优于对照组；（3）实验组的呼吸抑制情况的发生低于对照组。结论布托啡诺能够安全、有效地避免瑞芬太尼麻醉后痛觉过敏现象的发生。

Clinical research of Butorphanol in preventing hyperalgesia after Remifentanil anesthesia

Objective To assess the analgesic effect and safety of Butorphanol by studying its preventing role on hyperalgesia after awakening followed Remifentanil anesthesia. Methods Sixty patients （ASA Grading Ⅰ～Ⅱ grade） who underwent Remifentanil anesthesia for laparoscopic cholecystectomy were selected and randomly assigned into two groups equally. The patients in experimental group were administrated Butorphanol 30 μg/kg by intravenous injection, while the control group was given physiological saline. The operation time, time to opening eye and incubation time of both groups were observed and compared; VAS score, Ramsay score, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate （HR）, oxygen saturation （Sp02）, and respiratory depression incidence at T1（before the induction of Butorphanol）, T2（patients awakening）, T3（one hour after patients awakening）, T4（6 hours after patients awakening） were compared. Results （1）The operation time, time to opening eye, and extubation time of both groups were similar and difference was not significant; （2）At T2 and T3 point, the Ramsay scores of experimental group were superior to those of control group; at T4 point, the Ramsay scores and VAS score of trial group were superior to those of control group; （3）The respiratory depression incidence of trial group was lower than that of control group. Conclusion Butorphanol can effectively and safely avoid the occurrence of hyperalgesia after Remifentanil anesthesia.