布托啡诺复合罗哌卡因用于乳腺癌术后硬膜外镇痛的效果及安全性

目的 观察布托啡诺复合罗哌卡因用于乳腺癌术后硬膜外镇痛的效果与不良反应.方法 选择60例在连续硬膜外麻醉下行乳腺癌改良根治术的患者,随机分为布托啡诺复合罗哌卡因镇痛组（B组,n=30）和吗啡复合罗哌卡因镇痛组（M组,n=30）,术后硬膜外镇痛,B组给予20 mg/L布托啡诺＋1 g/L罗哌卡因 M组给予20 mg/L吗啡＋1 g/L罗哌卡因.两组所用镇痛泵容量均为100 ml,背景剂量2 ml/h,自控给药量2 ml/h,锁定时间15 min.术后持续监测血压、心率、血氧饱和度.观察术后5 h、10 h、20 h、30 h不同时段疼痛评分及有无恶心呕吐、皮肤瘙痒、呼吸抑制等不良反应.结果 两组患者术后不同时段镇痛效果,VAS评分差异无统计学意义（P〉0.05）.对平均动脉压、心率、血氧饱和度等生理指标的影响,两组差异无统计学意义.B组恶心呕吐、皮肤瘙瘁的发生率明显低于M组（P〈0.05）,两组均未出现明显的呼吸抑制.结论 布托啡诺复合罗哌卡因用于乳腺癌术后硬膜外镇痛效果满意,安全,不良反应少.

The analgesic effects with butorphanol plus ropivacaine for postoperative epidural analgesia after mastectomy

Objective To observe the analgesic effects and adverse reaction with bntorphanol plus ropivaeaine for postoperative epidural analgesia after masteetomy. Methods Select 60 cases of continuous epidural anesthesia in patients with modified radical masteetomy were randomly divided into butorphanol analgesic compound ropivaeaine group （ B group, n = 30）, and morphine combined with ropivaeaine analgesia group （M group, n = 30 ）, B group were given 20 mg/L butorphanol ＋ 1 g/L ropivaeaine, M group were given 20 mg/L morphine ＋ 1 g/L rupivaealne for epidural analgesia. The Analgesia capaeity which was used for the two groups was 100 ml, Background dose was 2 ml/h, the amount of self - control drug delivery was 2 ml/h, lock the time 15 rain. Observed the pain seores and the adverse reactions at different times. Results Two different times of postoperative analgesia and VAS score difference were not statistically significant （ P 〉 0. 05 ）. On some effect of physiological indicators, the two groups had no significant difference. Conclusion The effect and safety of butorphanol plus ropivaeaine in PCEA for patients undergoing radical operation for breast cancer was fine.