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

摘要

Objective to study the analgesic effect of lappaconitine combined with butorphanol in elderly patients after rectal can-cer operation with patient-controlled intravenous analgesia. Methods 60 patients with rectal cancer operation under general anes-thesia 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 seda-tion 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 .%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。