布托啡诺用于减轻阑尾手术中牵拉反应的临床观察

目的：研究布托啡诺减轻在硬膜外阻滞下行阑尾切除术时牵拉反应的效果。方法：选择ASAⅠ～Ⅱ级在硬膜外麻醉下行阑尾切除术病人70例，随机分成布托啡诺组 (B组) 和氟芬合剂组 (F组) ,每组35 例。B组在切皮时注入布托啡诺0.04mg/kg，F组注入氟哌利多0.05mg/kg，芬太尼0.02mg/kg。观察给药前5min、后5min及手术探查时病人HR、MAP、SpO2 及牵拉反应情况、术中病人的镇静评分及恶心、呕吐、头晕、瘙痒等不良反应情况。结果：F组病人生命体征的波动较B组更为剧烈，呼吸抑制发生率更高。头晕、恶心、呕吐、瘙痒等不良反应，镇静效果及对牵拉反应的减轻效果两组间基本无差异。结论：布托啡诺可安全有效地用于减轻阑尾手术时的牵拉反应。

Clinical Observation of Butorphal in Lessening Dragging Reaction During Appendectomy

Objective: To investigate the effects in lessening dragging reaction with butorphal during appendectomy under epidural blockade. Methods:70 ASA Ⅰ～Ⅱ undergoing appendectomy under epidural blockade were divided into two groups randomly.Butorphal group(group B,35 cases) and Fentanyl with droperidol group(group F,35 cases).In group A,Butorphal 0.04mg/kg was injected,in group F,fentanyl 0.02mg/kg and droperidol 0.05mg/kg were administered at skin incision.The indexs of HR,MAP,SPO2 at 5 min before and after administering the drug and during operation research,dragging reaction status and patients’ sedation scale were recorded. Adverse effects,including nausea,vomit,dizziness,pruritus were observated. Results:Vital sign of Group F changed more intensely, respiratory depression occurance rate was higher.There were no difference in other adverse effect , sedation scale and the effects in lessening dragging reaction between the two groups. Conclusion:Butorphanl can be administered safe and effectly in lessening dragging reaction of appendectomy under epidural blockade