布托啡诺超前镇痛用于鼻内镜手术的临床观察

【摘要】  目的：观察布托啡诺注射液对鼻内镜术术后的镇痛效果及超前镇痛作用。方法：选择择期行鼻内镜手术患者 80例，采用随机方法分为术前给药组(Ⅰ组)和对照组(Ⅱ组 )，每组各40名。Ⅰ组于术前 15 min 缓慢静脉注射布托啡诺1mg，Ⅱ组不给药，分别观察术后2、4、8、12 h和24 h的视觉模拟量表(VAS)评分。结果：Ⅰ组术后2、4、8、12 h VAS评分均显著低于Ⅱ组(P<0.05)，但术后24 h比较，差异无统计学意义(P>0.05)。结论：布托啡诺注射液术前给药可有效缓解鼻内镜术术后疼痛。

【关键词】  布托啡诺;鼻内镜术;术后镇痛;超前镇痛

Preemptive analgesia with Butorphanol in patients undergoing endoscopic nasal surgery JIANG De-bin，YU Jun-xiong，TAN Yong-xing，et al (Department of Anaesthesiology，the Affiliated Hospital of Guilin Medical College，Guilin 541001，China)

　　Abstract：ObjectiveTo observe the effect of Butorphanol′s postoperative analgesia and preemptive analgesia in patients undergoing endoscopic nasal surgery.MethodEighty patients undergoing elective endoscopic nasal surgery were randomly divided into two groups (40 case in each group)：Butorphanol postoperative analgesia group (groupⅠ) and control group(groupⅡ).The patients of group Ⅰwere slowly injected 1 mg Butorphanol 15 min before operation，but the patients of group Ⅱwith no treatment.Postoperative 2，4，8，12 and 24 h pain score was recorded by visual analogue scale (VAS).ResultsVAS scores of group Ⅰpostoperative 2，4，8 and 12 h were significantly lower than group Ⅱ(P<0.05).VAS scores of group Ⅰpostoperative 12 h lower than group Ⅱ，but there was no significant difference postoperative 24 hours.ConclusionPreoperative treatment with Butorphanol can effectively relieve postoperative pain of endoscopic nasal surgery.

　　Key Words:Butorphanol;Endoscopic nasal surgery;Postoperative analgesia;Preemptive analgesia

　　鼻内窥镜手术因其创伤小、恢复快等优势，而在临床上广泛应用，但患者术后疼痛依然存在，尤其是术后24 h。。布托啡诺是混合型阿片受体激动拮抗剂,在鼻内镜术后镇痛方面的研究比较少。通过对其超前镇痛的有效性及安全性的研究，为鼻内窥镜手术患者术后疼痛治疗探索一种新的治疗方法。

　　1 临床资料

　　1.1 一般资料：选择进行鼻内窥镜下手术患者80例，ASA分级为Ⅰ～Ⅱ级，年龄20～56岁。无严重心、肺、肝、肾及精神疾病,无吸毒、酗酒史，术前72h内未应用镇痛类药物。随机分成Ⅰ组(40例)于手术前15 min静脉推注布托啡诺1 mg;Ⅱ组(40例)于手术前静脉推注生理盐水1 ml。

　　1.2 麻醉方法：麻醉前30 min 肌内注射鲁米那0.1 g，阿托品0.5

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