何蕾 1 , 張小洺 2 , 徐亮 1
  • 1 武漢市第三醫(yī)院麻醉科（武漢，430060）;2 華中科技大學(xué)協(xié)和醫(yī)院麻醉科;

目的 　觀察酒石酸布托啡諾與芬太尼合用于術(shù)后靜脈自控鎮(zhèn)痛（PCIA）的效果及最佳混合比例。 方法 　2010年8月－2011年1月100例婦科手術(shù)患者，隨機(jī)分為5組，每組20例。均全身麻醉術(shù)后采用負(fù)荷量+持續(xù)背景劑量+PCIA方案鎮(zhèn)痛。根據(jù)不同配方分為F組：芬太尼1 mg+生理鹽水至100 mL；B組：酒石酸布托啡諾10 mg+生理鹽水至100 mL；BFⅠ組：芬太尼0.6 mg+酒石酸布托啡諾3 mg+生理鹽水至90 mL；BFⅡ組：芬太尼0.5 mg+酒石酸布托啡諾5 mg+生理鹽水至100 mL；BFⅢ組：芬太尼0.3 mg+酒石酸布托啡諾6 mg+生理鹽水至90 mL。觀察術(shù)后各時(shí)點(diǎn)視覺模擬評(píng)分（VAS）及鎮(zhèn)靜評(píng)分，患者滿意度以及不良反應(yīng)情況。 結(jié)果 　術(shù)后早期BFⅢ組和B組VAS評(píng)分大于F組；鎮(zhèn)靜評(píng)分B組大于F組；B組滿意度優(yōu)良率小于其余各組；惡心嘔吐發(fā)生率F組高于BFⅠ組及BFⅡ組。 結(jié)論 　酒石酸布托啡諾和芬太尼合用于PCIA，鎮(zhèn)痛效果確切，不良反應(yīng)發(fā)生率低。推薦配比：BFⅠ組和BFⅡ組。

引用本文： 何蕾,張小洺,徐亮. 酒石酸布托啡諾與芬太尼聯(lián)合用于婦科患者術(shù)后靜脈自控鎮(zhèn)痛的臨床研究. 華西醫(yī)學(xué), 2012, 27(3): 375-378. doi: 復(fù)制

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13. 　Dawn AG, Yosipovitch G. Butorphanol for treatment of intractable pruritus[J]. J Am Acad Dermatol, 2006, 54(3 ): 527-531.
14. 　何紹明, 周寧, 李輝, 等. 布托啡諾與芬太尼聯(lián)合用于術(shù)后病人自控靜脈鎮(zhèn)痛[J]. 臨床麻醉學(xué)雜志, 2007, 23(8): 643-644.
  1. 1. 　Bonnet F, Vésinet C. How can we improve the efficacy of morphine analgesia without increasing adverse effect?[J]. Can Anaesthesiol, 1994, 42(2): 191-194.
  2. 2. 　Bonnet F, Vésinet C. A review of the use of fentanyl analgesia in the management of acute pain in adults[J]. Anesthesiology, 1999, 90(2): 576-599.
  3. 3. 　ChangKJ, Wei ET, Killian A, et al. Potent morphiceptin analogs: structure activity relationships and morphine-like activities[J]. J Pharmacol Exp Ther, 1983, 227(2): 403-408.
  4. 4. 　Gilman AG, Goodman LS, Gilman A, et al. Pharmacological basis of therapeutics[M]. 8th ed. New York: Macmillan, 1990: 508-513.
  5. 5. 　Dunteman E, Karanikolas M, Filos KS. Transnasal butorphanol for the treatment of opioid-induced pruritus unresponsive to antihistamines[J]. J Pain Symptom Manage, 1996, 12(4): 255-260.
  6. 6. 　Gramer HR, Burke TF, Lawhorn CD, et al. Butorphanol-mediated antinociception in mice: partial agonist effects and Mu receptor involvement[J]. J Pharmacol Exp Ther 1997, 282(3): 1253-1261.
  7. 7. 　Butelman ER, Winger G, Zemig G, et al. Butorphanol: characterization of agonist and antagonist effects in rhesus monkeys[J]. J Pharmacol ExP Ther, 1995, 272(2): 845-853.
  8. 8. 　Preston KL, Bigelow GE, Liebson LA. Discrimination of butorphanol and nalbuphine in opioid-dependent humans[J]. Pharmacol Biochem Behav, l990, 37(3): 511-522.
  9. 9. 　Bowdle TA, greichen SL, Bjustrom RL, et al. Butorphanol improves CO2 response and ventilation after fentanyl anesthesia[J]. Anesth analg, l987, 66(6): 517-522.
  10. 10. 　Lawhorn CD, McNitt JD, Fibuch EE, et al. Epidural morphine with butorphanol for postoperative analgesia after cesarean delivery[J]. Anesth Analg, 1991, 72(1): 53-57.
  11. 11. 　王勝, 王志萍, 齊敦益. 布托啡諾在術(shù)后靜脈PCA鎮(zhèn)痛中的有效性及安全性研究[J]. 徐州醫(yī)學(xué)院學(xué)報(bào), 2006, 26(2): 132-134.
  12. 12. 　趙俊, 劉俊杰. 現(xiàn)代麻醉學(xué)[M]. 2版. 北京: 人民衛(wèi)生出版社, 1997: 314-318.
  13. 13. 　Dawn AG, Yosipovitch G. Butorphanol for treatment of intractable pruritus[J]. J Am Acad Dermatol, 2006, 54(3 ): 527-531.
  14. 14. 　何紹明, 周寧, 李輝, 等. 布托啡諾與芬太尼聯(lián)合用于術(shù)后病人自控靜脈鎮(zhèn)痛[J]. 臨床麻醉學(xué)雜志, 2007, 23(8): 643-644.