布托啡诺超前镇痛用于臂丛神经阻滞的临床观察

目的:观察布托啡诺超前镇痛对臂丛神经阻滞麻醉效果的影响。方法:选择60例择期甲状腺手术的患者,随机分为2组,每组30例,A组、B组分别注入酒石酸布托啡诺1 ml和安慰剂1 ml,5 min后均用0.375%左旋布比卡因行臂丛阻滞。分别记录术中的血压、心率、脉搏、血氧饱和度,感觉阻滞起效时间、运动阻滞起效时间、感觉阻滞持续时间、运动阻滞持续时间、麻醉维持时间、手术时间,评价麻醉效果、术后各时间点的疼痛评分。记录术后24 h内恶心、呕吐、头晕、头痛、寒战等不良反应发生率。结果:感觉阻滞、运动阻滞持续时间及镇痛持续时间A组均明显长于B组(P<0.01);A组术后4、8、12、24h VAS评分明显低于B组(P<0.01)。结论:布托啡诺超前镇痛效果确切,能够增强左旋布比卡因臂丛神经阻滞的效果,延长术后镇痛时间,不良反应发生率低,值得临床应用。

Clinical observation of Butorphanol preemptive analgesia for brachial plexus nerve block

Objective To observe the effects of Butorphanol preemptive analgesia on braehial plexus nerve block. Method Total 60 cases of elective thyroid surgery were randomly divided into two groups ,30 cases in each group. Group A and group B were injected butorphanol tartrate （ 1ml） and placebo （ 1ml） , respectively ,5 min later both were blocked with 0. 375% levobupivaealne card in braehial plexus. Intraoperative blood pressure, heart rate, pulse, oxygen saturation, sensory block onset time, motor block onset time, duration of sensory block, motor block duration, anesthesia duration, operative time, evaluation of anesthesia and postoperative pain score at different time points were recorded. The incidence of adverse reactions as postoperative nausea, vomiting, dizziness, headache, chills,etc within 24 h were recorded. Results Sensory block, motor block duration and the duration of analgesia in group A were significantly longer than group B （ P 〈 0. 01 ）. Postoperative 4,8,12,24 h VAS score in group A were significantly lower than group B（ P 〈 0. 01 ）. Conclusion Butorphanol has the exact preemptive analgesia effects, can enhance the effect of levobupivaeaine in braehial plexus block, extend the time for postoperative analgesia,with low incidence of adverse reactions,and it is worthy of clinical use.