布托啡诺经鼻给药超前镇痛对老年患者H-UPPP术后镇痛的影响

发布时间：2018-06-25 15:01

本文选题：布托啡诺 + 经鼻腔给药　；参考：《中国现代医学杂志》2015年09期

【摘要】：目的评价布托啡诺经鼻给药超前镇痛对改良悬雍垂腭咽成形术(H-UPPP)的老年患者术后镇痛的影响。方法选择全身麻醉下行H-UPPP术的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)老年男性患者140例,采用随机数字表法,将其分为四组(n=35):布托啡诺经鼻给药超前镇痛组(A组)、布托啡诺经静脉给药超前镇痛组(B组)、芬太尼经鼻给药超前镇痛组(C组)及对照组(D组)。于麻醉诱导前10 min,A组和B组分别经鼻和经静脉给予布托啡诺2 mg;C组经鼻给予芬太尼0.1 mg;D组静脉注射等容量生理盐水。术毕立即接镇痛泵行PCIA。记录术中舒芬太尼和丙泊酚及术后芬太尼的用量。于术后1、6、12、18、24、36及48 h(T1-7)时行VAS评分和BCS评分,统计术后镇痛期间不良反应的发生情况。结果与D组比较,A组、B组及C组的舒芬太尼用量减少,A组和B组恶心、呕吐发生率降低,A组T2-7时、B组T2-5时及C组T2-3时VAS评分降低,BCS评分升高;与C组比较,A组和B组恶心、呕吐降低,A组T4-7时、B组T4-5时VAS评分降低,BCS评分升高;与B组比较,A组T6-7时VAS评分降低,BCS评分升高(P0.05)。术后芬太尼用量A组低于B组、C组及D组(P0.05)。结论布托啡诺经鼻给药超前镇痛可有效地抑制OSAHS老年患者H-UPPP术后疼痛,且可减少术后镇痛药用量,其临床效果优于静脉给药和芬太尼经鼻给药途径。
[Abstract]:Objective to evaluate the effect of butorphanol preemptive analgesia on postoperative analgesia in elderly patients with modified uvulopalatopharyngoplasty (H-UPPP). Methods 140 elderly male patients with obstructive sleep apnea hypopnea syndrome (OSAHS) undergoing H-UPPP under general anesthesia were selected. They were divided into four groups: butorphanol group (group A), butorphanol group (group B), fentanyl group (group C) and control group (group D). 10 minutes before anesthesia induction, group A and group B were given butorphanol 2 mg / g by nasal and intravenous administration respectively. Group D was given fentanyl 0.1 mg / g intravenously by intravenous injection of normal saline. At the end of operation, the analgesic pump was immediately followed by PCIA. The dosage of sufentanil, propofol and postoperative fentanyl were recorded. VAS scores and BCS scores were measured at 1: 6, 12, 18, 24, 36 and 48 h (T1-7), and the adverse reactions during postoperative analgesia were counted. Results compared with group D, the dosage of sufentanil in group A and group C decreased nausea and vomiting in group A and group B, the incidence of nausea and vomiting in group A decreased, the VAS score decreased in group B at T2-5 at T2-7 in group A and that in group C at T2-3, and the scores of VAS in group A and group B were higher than those in group C, and nausea in group A and group B were significantly decreased. Compared with group B, VAS score at T6-7 in group A decreased and BCS score increased at T4-5 in group B (P0.05). Postoperative fentanyl dosage in group A was lower than that in group B, group C and group D (P0.05). Conclusion preemptive analgesia by nasal administration of butorphanol can effectively inhibit postoperative pain and reduce postoperative analgesic dosage in OSAHS aged patients with H-UPPP. The clinical effect of butorphanol is better than intravenous administration and fentanyl via nasal administration.
【作者单位】：大连医科大学附属第一医院神经电生理科;大连医科大学附属第一医院麻醉科;
【分类号】：R614

【参考文献】