布托啡诺用于剖宫产术镇痛效果观察

目的 观察布托啡诺用于剖宫产手术的镇痛效果。方法将60例行剖宫产孕妇随机分为布托啡诺组、吗啡组和对照组各20例，三组均行腰硬联合阻滞麻醉，注入腰麻药液后布托啡诺组注入布托啡诺1mg，吗啡组予吗啡2mg，均用生理盐水稀释至5ml；对照组注射生理盐水5ml。观察新生儿出生1、5min的Apgar评分，生后15min的神经行为和适应能力评分（NACS）；术中及术后2、4、8、12、24h的VAS评分及不良反应。结果三组Apgar评分、NACS评分比较无统计学差异；布托啡诺组术中探查痛及宫缩痛的VAS评分明显低于对照组。布托啡诺组和吗啡组术后2、4、8、12、24h的VAS评分明显低于对照组。布托啡诺组恶心、呕吐及皮肤瘙痒、呼吸抑制发生率明显低于吗啡组。结论布托啡诺用于剖宫产手术镇痛安全有效，且不良反应少。

Efficacy of butorphanol analgesia in caesarean section

Objective To investigate the efficacy of hutorphanol for analgesia in caesarean section Methods Sixty eases under going elective caesarean section were randomly divided into butorphanol group , morphine group and control group with 20 in each . All the three groups were given combined spinal epidural （CSEA） anesthesia. Then the butorphanol group and the morphine group were given 1 mg butorphanol and 2 mg morphine by epidural , both diluted to 5 ml with NS, while the control group were given 5 ml NS. Neonatal Apgar scoring for 1 rain and 5 min were recorded, neonatal neurologic and Adaptive Capacity Scores （NACS） were assessed at 15 min after birth （NACS） ,VAS scoring during operation and 2,4,8,12,24 h postoperatively and side effects after operation were recorded. Results There was no significant difference among the three groups in neonatal Apgar scoring and the Neonatal neurologic and Adaptive Capacity Scores （NACS） The VAS scoring of exploration pain and uterine contraction pain during operation in the butorphanol group was lower than that in the control group. The VAS scorning 2,4,8,12,24 h after the operation in the butorphanol group and the morphine group were lower than that in the control group. However the incidence of side effects including pruritus, nausea ,vomiting and respiratory depression in the butorphanol group waslower than that int the morphine group obviously. Conclusion Butorphanol for postoperative analgesia is safe and effective, also has fewer side effects.