摘要
目的 比较静脉和硬膜外丁丙诺啡术后镇痛效果。方法 50例ASAⅠ～Ⅱ级全麻下行上腹部择期手术病人随机均分二组：患者完全清醒并诉切口疼痛时，V组经静脉注射丁丙诺啡0．2mg，E组经硬膜外注射丁丙诺啡0．2mg，记录镇痛起效时间和维持时间。患者再次疼痛（VAS〉5）时分别开启静脉和硬膜外病人自控镇痛泵，采用LCP模式。结果 两组病人的镇痛效果均满意，V组和E组镇痛起效时间分别为（9±3）min．和（25±5）min．，维持时间分别是（5．1±2．3）h和（12．3±4．5）h，E组明显长于V组（p〈0．05）；两组使用丁丙诺啡总量分别为（1．0±0．4）mg和（0．6±0．2）mg；4h及22hE组VAS评分较低。两组RameSay镇静评分及不良反应无显著差异。结论 静脉和硬膜外注射丁丙诺啡用于上腹部手术术后镇痛安全而有效，静脉注射镇痛起效更快，硬膜外注射可减少其用药总量，延长维持时间。
Objective To compare the efficacy within venous and epidural buprenorphine in postoperative pain relief. Method Fifty ASA Ⅰ-Ⅱ patients scheduled for upper abdominal operation under general anesthesia were randomized into one of two groups, venous group or epidural group. After recovery from anesthesia, patient received 0.2 mg buprenorphine either intravenously or eidurally, time of onset and duration of analgesia were recorded. Patient controlled venous or epidural analgesia started when the pain came back. Result Mean onset time and duration of analgesia in venous group were 9 min and 5 hrs, which were significantly short than those in epidural group, 25 min and 12.3 hrs. Total dose of buprenorphine in venous group （1.0 mg） was more than that in epidural group （0.6 mg） ,P〈0.05. Conclusion Both venous and epidural buprenorphine are safe and effective in relieve the pain after upper abdominal operation, buprenorphine injected epidurally has some advantage in saving the dose and prolonging the duration of analgesia when compared with administered venously.
出处
《国际医药卫生导报》
2007年第3期42-44,共3页
International Medicine and Health Guidance News
关键词
丁丙诺啡
疼痛
手术后
镇痛
硬膜外
Buprenorphine Pain Postoperative Analgesia Epidural
