布托啡诺与芬太尼用于剖宫产术後静脉镇痛（PCIA）临床效果观察

目的观察布托啡诺用于剖宫产术後病人自控静脉镇痛效果与副作用。方法选择ASA Ⅰ～Ⅱ级足月单胎妊娠产妇40例，随机分为两组，布托啡诺组（B组）及芬太尼组（F组），均选择小剂量氯胺酮静脉全麻进行剖宫产手术。术後分别给予布托啡诺9mg及芬太尼0．9mg分别用0．9％N.S稀释至100ml注入镇痛泵用于术後病人自控静脉镇痛。使用视觉模拟评分法（VAS）及镇静评分法Ramesay评分法，观察两组病人术後各时间段的疼痛评分、镇静评分以及术後恶心、呕吐情况。结果术後4h内两组VAS评分有显着差异，B组优于F组。两组术後各时间段的镇静评分：B组高于F组，其差异有显着性。两组术後48小时以内恶心、呕吐、嗜睡的发生率比较均无统计学差异。结论本研究观察表明，布托啡诺与芬太尼均是安全的镇痛剂，用于剖宫产的病人术後的静脉镇痛效果确切，副作用少，且布托啡诺用于剖宫产术後静脉镇静效果优于芬太尼。

Clinical Observation of Butorphanol And Fentanyl In PCIAFor Post Cesarean Section

Objectives to observe and compare the efficacy and safety between butorphanol and fentanyl for post cesarean section with patient self-controlled intravenous analgesia（PCIA）. Methods forty patients （A-SA Ⅰ～Ⅱ） undergoing cesarean section with small dose ketamine intravenous anesthesia were randomly divided into two groups. B group were given Butorphanol 9mg in analgesic pump, and F group were given fentanyl 0.9mg. Postoperative pain was assessed using VAS （Visual Analogue Score）, sedation grades was assessed using Ramesay Score and the side reactions, such as nausea, vom- iting, were observed. Results the efficacy and safety between butorphanol and fentanyl for cesarean section with PCIA were satisfied. The VAS scores of study group were significantly less than group F （P〈0.05）, at 4h after cesarean section. And the sedation grades group B were significantly higher （P〈0.05）. The incidence of nausea and vomiting was same. Conclusion are effective and safe The section grades of than that of fentanyl. both butorphanol and fentanyl in PCIA for cesarean section. butorphanol are more effective than that of fentanyl.