Clinical Study of Combined Butorphanol with Fentanyl in Patient Controlled Intravenous Analgesia for Gynecologic Surgery Patients_West China Medical Journal

Authors：

HE Lei ¹ , ZHANG Xiaoming ² , XU Liang ¹

1. Department of Anethesiology, the Third Hospital of Wuhan, Wuhan, Hubei 430060, P. R. China; 2. Department of Anethesiology, Union Hospital of Huazhong University of Science and Technology, Wuhan, Hubei 430074, P. R. China;

Corresponding author：

Keywords：

布托啡诺; 芬太尼; 静脉自控镇痛; 视觉模拟评分; 镇静评分; 不良反应

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目的　观察酒石酸布托啡诺与芬太尼合用于术后静脉自控镇痛（PCIA）的效果及最佳混合比例。方法　2010年8月－2011年1月100例妇科手术患者，随机分为5组，每组20例。均全身麻醉术后采用负荷量+持续背景剂量+PCIA方案镇痛。根据不同配方分为F组：芬太尼1 mg+生理盐水至100 mL；B组：酒石酸布托啡诺10 mg+生理盐水至100 mL；BFⅠ组：芬太尼0.6 mg+酒石酸布托啡诺3 mg+生理盐水至90 mL；BFⅡ组：芬太尼0.5 mg+酒石酸布托啡诺5 mg+生理盐水至100 mL；BFⅢ组：芬太尼0.3 mg+酒石酸布托啡诺6 mg+生理盐水至90 mL。观察术后各时点视觉模拟评分（VAS）及镇静评分，患者满意度以及不良反应情况。结果　术后早期BFⅢ组和B组VAS评分大于F组；镇静评分B组大于F组；B组满意度优良率小于其余各组；恶心呕吐发生率F组高于BFⅠ组及BFⅡ组。结论　酒石酸布托啡诺和芬太尼合用于PCIA，镇痛效果确切，不良反应发生率低。推荐配比：BFⅠ组和BFⅡ组。

Citation： HE Lei,ZHANG Xiaoming,XU Liang. Clinical Study of Combined Butorphanol with Fentanyl in Patient Controlled Intravenous Analgesia for Gynecologic Surgery Patients. West China Medical Journal, 2012, 27(3): 375-378. doi: Copy

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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. 　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. 　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. 　Gilman AG, Goodman LS, Gilman A, et al. Pharmacological basis of therapeutics[M]. 8th ed. New York: Macmillan, 1990: 508-513.
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. 　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. 　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. 　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. 　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. 　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. 　王胜, 王志萍, 齐敦益. 布托啡诺在术后静脉PCA镇痛中的有效性及安全性研究[J]. 徐州医学院学报, 2006, 26(2): 132-134.
12. 　赵俊, 刘俊杰. 现代麻醉学[M]. 2版. 北京: 人民卫生出版社, 1997: 314-318.
13. 　Dawn AG, Yosipovitch G. Butorphanol for treatment of intractable pruritus[J]. J Am Acad Dermatol, 2006, 54(3 ): 527-531.
14. 　何绍明, 周宁, 李辉, 等. 布托啡诺与芬太尼联合用于术后病人自控静脉镇痛[J]. 临床麻醉学杂志, 2007, 23(8): 643-644.

West China Medical Journal

Clinical Study of Combined Butorphanol with Fentanyl in Patient Controlled Intravenous Analgesia for Gynecologic Surgery Patients

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