麻醉科用药专栏
YU Honghui;LUO Ailin;ZHOU Biyun;CHEN Yinghong;TIAN Yuke
2007, 26(9): 999-1001.
ABSTRACTObjectiveTo compare the analgesic effects of varying regimens of butorphanol on patientcontrolled intravenous analgesia. MethodsOne hundred ASAⅠⅡ patients(3267 years) scheduled for elective orthopedic surgery under general anesthesia were divided randomly into four groups, 25 patients in each group. Group A received fentanyl 20 μg·mL-1, group B1 , butorphanol 0.1 mg·mL-1, group B2 ,butorphanol 0.2 mg·mL-1 and group B3 , butorphanol 0.4 mg·mL-1. The patients received PCIA when they were sent to postoperative recovery room with loading dose 2 mL, bolus 2 mL, and lockout time 10 minutes. Pain scores, drug consumption, sedative scores, blood pressure, respiratoy rate, SpO2 and HR were assessed at 0, 1, 4, 8, 12 and 24 hours after analgesia. The patients were considered having analgesia as uncomfortable when their VAS＞3. Respiratory depression, nausea and vomiting, and pruritus were recorded . ResultsVAS in group B1 was significantly higher than that in groups B2 and B3 at 1 h and 4 h(P＜0.05＝；moreover, the number of VAS＞3 was significantly higher in group B1 as compared with that in other groups(P＜0.05＝. In addition, we found that the sedative score in group B3 after the beginning of analgesia was higher than that in other groups, and the difference was significant at 1 h after analgesia(P＜0.05＝; furthermore, 21% patients (5/24) in group B3 had an incidence of over sedation with sedation scores≥3 ,which was higher than other groups but not significant. The patients in three butorphanol groups had higher sedative score with less respiratory depression, nausea , vomiting, and pruritus as compared with those in fentanyl group. ConclusionButorphanol 0.2 mg·mL-1 provides the optimum balance between pain relief and side effects following orthopedic surgery.
