不同剂量布托啡诺对胃癌根治术后患者静脉自控镇痛效能的比较

目的观察不同剂量的布托啡诺对胃癌根治术后患者静脉自控镇痛效能的比较。方法选择行胃癌根治的患者232例,ASA为Ⅰ～Ⅱ级。将232例患者随机分为布托啡诺静脉自控镇痛组和对照组,每组均为29例。其中布托啡诺组分为6个小组,分别是布托啡诺浓度为0.004%、0.005%、0.006%、0.007%、0.008%和0.009%的A1、A2、A3、A4、A5和A6组。对照组分为2个小组,分别是吗啡浓度为0.025%的B1组以及传统方法治疗B2组。在胃癌根治术后1d观察患者情况,详细记录患者的舒适度评分、镇静度评分、视觉模拟评分以及患者的不良反应与PCIA的总按压频率次数和实际用药情况。结果①A3～A6组以及B1组的VAS评分明显低于B2和A1、A2组,而BCS的评分要高于B2和A1、A2组（P〈0.05）。②A3～A6组的PCIA总压次数明显低于A1、A2组,然而用药量远远高于A1、A2两组（P〈0.05）。③B1组患者腹胀、恶心、呕吐等不良症状发生频率远远高于A1～A6以及B2组患者（P〈0.05）。A6组患者的嗜睡程度最高。A1、A2组需要其他镇痛药物辅助,镇痛效果才能达到A3～A6组。结论布托啡诺的浓度为0.006%、0.007%时,以0.0022～0.0026mg/（kg.h）的速率给药,负荷剂量为0.005mg/（kg.h）的静脉PCIA会获得最佳的镇痛疗效,并且不良反应的发生率极低,可以应用于相关临床疾病的治疗中。

Different amount of butorphanol gastric carcinoma radical surgery after sufferer vein from control the comparison of pain effect in the town

Objective Research and inquire into the different cloth for measuring giving an agree with stomach cancer of Fei promise to cure for good the Shu future trouble vein from control the comparison of pain effect in the town.Methods Choosing to cure for good the sufferer of stomach cancer after surgical operation treatment is 232,all belong to the ASA ratings as Ⅰ class or Ⅱclass.Is divided into 232 stomach cancer sufferers immediately the cloth give a Fei promise vein from control pain set in the town and matched control,each group is 29.Give cloth Fei promise the set is divided into six groups,is a cloth to give the Fei promise＇s density as 0.004%,0.005%,0.006%,0.007%,0.008% and 0.009% A1,A2,A3,A4,A5 and A6 set respectively.The matched control is divided into two groups,respectively is a morphine density is 0.025% B1 set and traditional method to cure a B2 set.A day after the stomach cancer cures for good Shu the whole observation sufferer＇s circumstance,minute down a quiet degree of the patient＇s comfort index grade point,town in detail grade point,sense of vision emulation grade point and sufferer of bad reaction and PCIA of total press press frequency number of times and actual medicine circumstance.Results ①VAS grade points of A3～A6 set and B1 set are more obviously low than the B2 and the A1,A2 set,while the BCS grade point will be higher than the B2 and the A1,A2 set（P0.05） ②PCIAs of A3～A6 set always press number of times is more obviously low than A1,A2,B2 set,however with the medicine measure is farer far high than A1,A2 set（P0.05）.③ Use the sufferer whom the B1 set cures a method,their abdominal distension,disgusted,vomit etc.is bad symptom occurrence the frequency is farer far high than the sufferer of A1～A6 and B2 method treatments of use A6 set sufferer loves to sleep degree for tallest.A1,A2 two groups need to have the assistance of other analgesic things,then pain effect in the town can attain A3～A6 sets of As.Conclusion When cloth gave the density of Fei promise in 0.006%,0.007%,give with the of the velocity of per hour 0.002 2 mg/kg,0.002 6 mg/kg medicine,burden vein PCIA that measure for the per hour 0.005 mg/kg will the incidence rate acquiring the best pain curative effect in the town,and badly responding is the lowest,can be applied to related clinical paroxysm under medical treatment.