酒石酸布托啡诺在骨科上肢手术臂丛麻醉中超前镇痛的应用

摘要

OBJECTIVE To investigate the clinical efficacy and adverse reactions of Bhutto butorphanol tartrate ( Nuo Yang) in operation of upper limb for preemptive analgesia.METHODS Upper limb operation of brachial plexus anesthesia for 120 cases with interscalene block method,before the operation,60 cases in group A intravenous injection of tramadol 100mg,B group of 60 cases intravenous injection butorphanol tartrate Bhutto 1mg.RESULTS The onset time of anesthesia of the two groups had no significant difference ( P>0.05 ) ,anesthesia duration of group A was significantly shorter then group B (P<0.05);after operation 2.4.8.12.24h, VAS score of group A signifi-cantly higher than those in group B ( P<0.05 ) .CONCLUSION Tartaric acid Bhutto butorphanol in preemptive analgesia can enhance the effect for brachial plexus block.%目的：探讨酒石酸布托啡诺（诺扬）在上肢手术中超前镇痛的临床疗效及不良反应发生情况，方法选择上肢手术臂丛麻醉病例120例，ASAⅠ～Ⅱ级，随机分成两组，对照组（A组）和实验组（B组），每组60例。均使用肌间沟阻滞法，术前，A组给予静脉注射适量的曲马多，B组给予静脉注射适量酒石酸布托啡诺，记录A、B组术中麻醉起效时间、麻醉维持时间以及2h～24h各时间段的镇痛效果，并记录 A、B组不良反应的发生情况。结果 A、B组麻醉起效时间比较，差异无统计学意义（P ＞0．05），但麻醉维持时间相比较，A 组明显短于 B 组，（P ＜0．05）；A组术后2h、4h、8h、12h、24h，VAS评分明显高于B组（P＜0．05）。 A组患者恶心、呕吐发生率高于B组。结论骨科上肢手术前使用酒石酸布托啡诺行超前镇痛，有术中完全无痛率高，术中患者安静，术后镇痛时间明显延长等俱多优点。