多沙普仑减轻布托啡诺术后镇痛期嗜睡的临床研究

目的 观察多沙普仑对布托啡诺术后镇痛期嗜睡和VAS评分的影响.方法 全组均行硬膜外麻醉后,随机分为0.01%布托啡诺和0.1%多沙普仑镇痛泵组(组Ⅰ,n=35),0.01%布托啡诺和0.15%多沙普仑镇痛泵组(组Ⅱ,n=35)和0.01%布托啡诺镇痛泵组(组Ⅲ,n=35).比较术后镇痛效果和副作用.结果 3组均获得了满意的术后镇痛效果.镇静评分(OAA/S,术后8 h～24 h):组Ⅲ>组Ⅰ和组Ⅱ(分别P<0.01).SpO2(负荷剂量后0 min～30 min):组Ⅲ分别小于组Ⅰ和组Ⅱ.VAS评分(术后8h～24 h):组Ⅲ<组Ⅰ和组ⅡP<0.05,但3组VAS均≤3分,且D1/D2值3组互比P>0.05.其他副作用无统计学差异.结论 多沙普仑和布托啡诺合用能有效地减轻或消除布托啡诺术后镇痛期的嗜睡副作用,提高临床用药的安全性.

The clinical observation of doxapram attenuates somnolence induced by postoperative intravenous analgesia with butorphanol

Objective To observe whether doxapram can attenuate the degree of somnolence arising from butorphanol intravenous analgesia. Methods One hundred and five adult patients were randomly divided into three groups receiving continuous intravenous analgesia with 0.01% butorphanol and 0.1% doxapram analgesia-pump (group Ⅰ , n=35), 0.01% butorphanol and 0.15% doxapram analgesia-pump ( group Ⅱ , n=35 ), and 0.01% butorphanol analgesia-pump ( group Ⅲ, n = 35 ) after epidural block. The analgesia effect and lethargic side-effect were compared . Results OAA/S (at 8 h-24 h after operation ) in group Ⅲ was larger than those in group Ⅰ and Ⅱ (P <0.01, respectively ). SpO2(at 0 min-30 min after operation) in group Ⅲ was lower than those in group Ⅰ and Ⅱ(P <0.01 ). VAS scores (at 8 h -24 h after operation) in group Ⅲ, were significantly lower than those in group Ⅰ and group Ⅱ (P <0.01, and P >0.05, VAS ≤3 respectively). Side-effects between three groups were not significantly different. Conclusion Doxa-pram is effective for attenuating lethargy symptom during intravenous butorphanol analgesia with less side-effects.