酒石酸布托啡诺和曲马多用于舌癌术后静脉自控镇痛比较

目的:比较酒石酸布托啡诺和曲马多对舌癌术后静脉自控镇痛(PCIA)的效果。方法:81例ASAⅠ-Ⅲ择期在全身麻醉下行舌癌根治性手术患者,术后使用PCIA镇痛,并被随机分为2组使用不同镇痛药物,酒石酸布托啡诺组36例,曲马多组45例。采用视觉模拟评分法(VAS)评价两组患者术后即刻和术后6、24、48 h的镇痛、镇静程度,恶心呕吐等不良反应发生率,以及患者对术后镇痛的满意度等情况。结果:患者术毕即刻VAS评分,两组间差别没有统计学意义(P>0.05);术后6、24、48 h的VAS评分,曲马多组高于布托啡诺组,差异有统计学意义(P<0.05);术后48 h的不良反应发生率,曲马多组高于布托啡诺组(P<0.05);患者满意度方面,布托啡诺组不满意率较曲马多组低(P<0.05)。结论:酒石酸布托啡诺组对舌癌术后镇痛效果优于曲马多组,患者满意度高,可安全、有效的应用于舌癌术后镇痛。

Efficacy of Butorphanol and Tramadol for Postoperative Pain Control following Tongue Surgery

Objective： To compare the effects of patient-control intravenous analgesia （PCIA） with butorphanol tartrate and tramadol after tongue cancer operation. Methods： 81 ASA I -1I patients underwent tongue cancer surgery under general anesthesia were chosen to use PCIA and randomly divided into two groups： butorphanol group （36 cases） and tramadol group （45 cases）. After the patients received the PCIA, efficacy of postoperative hypnosis were assessed by visual analog scale （VAS） method at immediate postoperative recovery, and 6, 24 and 48 hours after respectively. Satisfaction with postoperative analgesia, the times of pushing button during the period of PCIA and side reactions were also measured. Results： The VAS score of immediate postoperative recovery showed no significant difference between two groups （P〉 0.05）; After 6, 24, 48 hours, the VAS score of tramadol group significantly higher than that in the butorphanol group （P〈 0.05）;After 48 hours, the side reaction rates of tramadol group was significantly higher than that in the butorphanol group （P〈0.05）, the satisfaction of tramadol group was also significantly lower than that in the butorphanol group （P〈0.05）. Conclusion： The analgesia effects of butorphanol were clearly better than tramadol, which could be used for the postoperative analgesia of tongue cancer surgery safely and effectively.