高乌甲素联合布托啡诺在老年直肠癌患者术后静脉镇痛中的临床分析(1)
[摘要] 目的 探讨高乌甲素联合布托啡诺用于老年直肠癌患者术后静脉自控镇痛(PCIA)中的效果。方法 60例择期在全身麻醉下行直肠癌根治术的患者随机分为三组：A组布托啡诺10 mg+托烷司琼5mg；B组，布托啡诺8 mg+高乌甲素20mg+托烷司琼5mg，C组，布托啡诺10 mg+高乌甲素20 mg+托烷司琼5 mg。观察并记录患者术后6 h.12 h.24 h.48 h疼痛。镇静评分、术后48 h内PCIA有效按压次数和术后不良反应的发生情况。 结果 与A组比较12～48 h时B.C组VAS评分降低(P<0.05)，6 ～48 h PCIA泵有效按压次数减少(P<0.05)，6～24 h时B组Ramsay镇静评分降低(P<0.05)；与C组比较6～24 h时B组Ramsay镇静评分降低(P<0.05)，3组均未出现明显不良反应。结论 老年直肠癌患者术后行布托啡诺联合高乌甲素PCIA，镇痛效果良好且不良反应减少。
[关键词] 布托啡诺；高乌甲素；老年直肠癌患者；静脉自控镇痛
[中图分类号] R614 [文献标识码] A [文章编号] 1674-0742(2015)03(a)-0107-03
Clinical Observation of Lappaconitine Combined With Butorphanol in Postoperative Intravenous Analgesia in Elderly Patients With Rectal Cancer
WANG Xueye1 ZHANG Tong jun2
1.Hengshui city MCH Anesthesiology， Hebei hengshui 053000 China；2.Harrison in tormational peace hospital， Hengshui City department of anesthesiology， Hebei hengshui 053000 China
[Abstract] Objective to study the analgesic effect of lappaconitine combined with butorphanol in elderly patients after rectal cancer operation with patient-controlled intravenous analgesia. Methods 60 patients with rectal cancer operation under general anesthesia were randomly divided into 3 groups .The patients who received butorphanol 10mg and tropisetron 5 mg were divided into group A.Butorphanol 8 mg combined with lappaconitine 20 mg and tropisetron 5 mg were group B. Butorphanol 10mg combined with lappaconitine 20 mg and tropisetron 5 mg were group C.Observe and record the pain score、sedation score at the time 6 h、12 h、24 h、48 h after surgery. Also record the incidence of postoperative adverse reaction and pressing times of PCIA within 48h. Results Compared with group A ， group B and group C have a lower VAS score at 12～48 h after surgery(P<0.05)，and decrease the effective pressing numbers of PCIA pump at 6～48 h(P<0.05).At the time 6～24 h， group B and group C decrease the Ramsey sedation score compared with group A (P<0.05)，and group C has a more lower Ramsey sedation score compared with group B (P<0.05).All of the three groups have no obvious adverse reactions. Conclusion The method can reduce the incidence of adverse reaction and has a good analgesic effect of lappaconitine combined with butorphanol in elderly patients after rectal cancer operation with patient-controlled intravenous analgesia .
[Key words] Butorphanol； Lappaconitine； Elderly patients with rectal cancer； Patient-controlled intravenous analgesia
老年直肠癌患者多伴有生理机能减退，手术耐受性差，术后恢复差。术后疼痛会对患者神经，内分泌功能造成影响，影响术后恢复，因此老年直肠癌患者术后镇痛的选择对其恢复甚为关键。布托啡诺镇痛效果良好，可很好的应用在术后静脉自控镇痛(PCIA)，但在临床工作中不规范使用仍可发生呼吸抑制。高乌甲素为非成瘾性镇痛药[1]，该研究将高乌甲素复合不同剂量布托啡诺用于老年直肠癌患者术后PCIA，对其安全性、有效性和不良反应发生情况进行临床评价，现报道如下。, 百拇医药(王雪叶 张同军)
[关键词] 布托啡诺；高乌甲素；老年直肠癌患者；静脉自控镇痛
[中图分类号] R614 [文献标识码] A [文章编号] 1674-0742(2015)03(a)-0107-03
Clinical Observation of Lappaconitine Combined With Butorphanol in Postoperative Intravenous Analgesia in Elderly Patients With Rectal Cancer
WANG Xueye1 ZHANG Tong jun2
1.Hengshui city MCH Anesthesiology， Hebei hengshui 053000 China；2.Harrison in tormational peace hospital， Hengshui City department of anesthesiology， Hebei hengshui 053000 China
[Abstract] Objective to study the analgesic effect of lappaconitine combined with butorphanol in elderly patients after rectal cancer operation with patient-controlled intravenous analgesia. Methods 60 patients with rectal cancer operation under general anesthesia were randomly divided into 3 groups .The patients who received butorphanol 10mg and tropisetron 5 mg were divided into group A.Butorphanol 8 mg combined with lappaconitine 20 mg and tropisetron 5 mg were group B. Butorphanol 10mg combined with lappaconitine 20 mg and tropisetron 5 mg were group C.Observe and record the pain score、sedation score at the time 6 h、12 h、24 h、48 h after surgery. Also record the incidence of postoperative adverse reaction and pressing times of PCIA within 48h. Results Compared with group A ， group B and group C have a lower VAS score at 12～48 h after surgery(P<0.05)，and decrease the effective pressing numbers of PCIA pump at 6～48 h(P<0.05).At the time 6～24 h， group B and group C decrease the Ramsey sedation score compared with group A (P<0.05)，and group C has a more lower Ramsey sedation score compared with group B (P<0.05).All of the three groups have no obvious adverse reactions. Conclusion The method can reduce the incidence of adverse reaction and has a good analgesic effect of lappaconitine combined with butorphanol in elderly patients after rectal cancer operation with patient-controlled intravenous analgesia .
[Key words] Butorphanol； Lappaconitine； Elderly patients with rectal cancer； Patient-controlled intravenous analgesia
老年直肠癌患者多伴有生理机能减退，手术耐受性差，术后恢复差。术后疼痛会对患者神经，内分泌功能造成影响，影响术后恢复，因此老年直肠癌患者术后镇痛的选择对其恢复甚为关键。布托啡诺镇痛效果良好，可很好的应用在术后静脉自控镇痛(PCIA)，但在临床工作中不规范使用仍可发生呼吸抑制。高乌甲素为非成瘾性镇痛药[1]，该研究将高乌甲素复合不同剂量布托啡诺用于老年直肠癌患者术后PCIA，对其安全性、有效性和不良反应发生情况进行临床评价，现报道如下。, 百拇医药(王雪叶 张同军)