摘要
[目的]评价新型镇痛药诺扬用于腹腔镜下胆囊切除术后镇痛的临床疗效、安全性及不良反应。[方法]45例接受腹腔镜胆囊切除术后的患者随机分成3组,每组15例,诺扬组1mg静脉滴注,芬太尼组50μg静脉滴注,空白对照组。观察静脉给药前,给药后0,5,10,15,30min时镇痛,镇静评分,心率,收缩压,呼气末二氧化碳,呼吸频率。术后1,2,3,4h镇痛评分(VAS),使用杜冷丁人数及不良反应。[结果]使用诺扬或芬太尼后,患者的疼痛评分降低(P=0.001),镇静评分升高(P=0.006)呼气末二氧化碳升高(P=0.02)。诺扬组患者的镇静评分高于芬太尼组(P﹤0.05),恢复室内诺扬组需追加止痛药的患者人数低于芬太尼组(13%vs33%,P﹥0.05),术后使用杜冷丁的人数低于芬太尼组(0vs13%,P﹥0.05)两组患者术后的不良反应无统计学差异。空白对照组患者的杜冷丁使用量,不良反应发生率高于诺扬组和芬太尼组(P﹤0.05)。[结论]腹腔镜术后病人按常规临床剂量使用诺扬镇痛能有效缓减术后疼痛,不良反应发生率低,诺扬临床镇静效果强于芬太尼,镇痛维持时间较长。
[Objective] To evaluate the post-operative analgesic efficacy, seettrity and side-effects of butorphanol compared to fentanyl. [ Methods] 45 patients undergoing laparoseopic cholecystectomy were recruited and divided into 3 groups ： butorphanol group （15 patients）, fentanyl group （15 patients） and control group （15 patients） . The index： the scores of sedation and pain intensity, HR, SBP, ETCO2, FF, were observed at the time of 0 min. 5 min, 10min, 15 min and 30 min before and after the treatment. Post-operative pain intensity was assessed at the time of lh, 2h, 3h and 4h, by recording visual analogue score （VAS）, the people who used meperidine and the adverse effects were recorded. [ Results] The scores of pain were lower and the scores of sedation were higher compared to premedical in butorphanol group and in fentanyl group （P 〈 0.05）. The scores of sedation was higher in butorphanol group than in fentanyl group （P 〈 0.05）. ETCO2 increased significantly in both butorphanol and fentanyl groups （P 〈 0.05）The demands of meperidine and the adverse effects showed no significant different in both butorphanol and fentanyl groups. （P 〉 0.05） but were greater in the control group when compared with both the butorphanol and fentanyl groups （P 〈 0.05 ）. [Conclusion ] These doses of butorphanol eotdd effectively reduce pain intensity after laparoseopic eholeeystectomy, the adverse effects were low. When compared to fentanyl, the degree of sedation was higher and the time of relieve pain was longer.
出处
《现代预防医学》
CAS
北大核心
2008年第18期3658-3660,共3页
Modern Preventive Medicine
关键词
诺扬
芬太尼
腹腔镜胆囊切除术
镇痛
随机对照研究
Butorphanol, Fentanyl
Laparoscopic cholecystectomy
Analgesia
Randomized control study
