摘要
目的评价布托啡诺超前镇痛对罗哌卡因肋间神经阻滞效果的影响。方法选择40例拟在肋间神经阻滞下行乳房病损切除术的女性患者,采用双盲法随机分成试验组(A组)和对照组(B组),每组各20例:A组患者于肋间神经阻滞前5min静脉推注布托啡诺20μg/kg,B组于肋间神经阻滞前5min静脉推注安慰剂(生理盐水)。两组均施行罗哌卡因肋间神经阻滞。对术中麻醉满意程度进行评价,记录麻醉起效时间、麻醉维持时间及恶心呕吐等不良反应发生率,分别于术后1、4、12、24h采用"视觉模拟评分法(VAS)"进行疼痛评分。结果术中麻醉满意程度A组优于B组,术后4、12h时疼痛评分A组显著低于B组(P<0.05),麻醉维持时间A组明显长于B组,两组比较差异有统计学意义(P<0.01)。结论术前静脉推注布托啡诺具有一定的超前镇痛效果,能够增强罗哌卡因肋间神经阻滞效果,延长术后镇痛时间,不良反应少,值得临床采用。
Objective To evaluate the clinical elects of Butorphanol preempitive analgesia on intercostal nerve block with ropivacaine. Methods Appling double blind method,40 adult male patients undergoing breast lesion resection operation on intercostal nerve block were divided randomly into test group （group A） and control group （group B） with 20 cases each. Every group received intercostal nerve block with ropivacaine. Group A （test group） intravenously injected the patient with butorphanol 20 μg/kg at 5 minutes before intercostal nerve block. Group B （control group）intravenous injected the patient with placebo （physiological saline） at 5 min before intercostal nerve block. The degree of intraoperative anesthesia satisfaction was evaluated. The onset time of anesthesia, the duration time of nerve blockade,the adverse reaction （eg nausea and vomiting） and VAS （the visual analogue scale）scores at 1,4,12,24 hours after operative were recorded. Results The degree of intraoperative anesthesia satisfaction in group A was better than that in group B （P 〈0. 05） ,The duration of nerve blockade in group A was obviously longer than that in group B（P 〈0. 01 ）. The scores of VAS at 4,12 h postoperative in group B was higher than that in group A（P 〈0. 05）. Conclusion Intravenously injecting butorphanol before operative have the efect of preempitive analgesia. It can potentiate the elects of intercostal nerve block with ropivacaine and prolong the time of postoperative analgesia and little adverse reaction,deserve the clinic adoption.
出处
《中国实用医药》
2009年第2期23-24,共2页
China Practical Medicine
关键词
布托啡诺
超前镇痛
肋间神经阻滞
罗哌卡因
Butorphanol
Preempitive analgesia
Intercostal nerve block
Ropivacalne
