布托啡诺超前镇痛用于隆乳术后镇痛的临床效果观察.docVIP

布托啡诺超前镇痛用于隆乳术后镇痛的临床效果观察 　　[摘要]目的：评价术前给予布托啡诺超前镇痛用于隆乳手术后患者静脉自控镇痛的临床效果。方法：于2013-8―2014-8间，选择ASA分级 I～II级，静脉全麻下行硅胶假体隆乳需术后镇痛患者120例，随机分为术前给药组（A组）和对照组（B组）各60例；A组术前30min给予酒石酸布托啡诺20μg/kg静脉滴注，B组术前给于等量生理盐水静脉滴注。结果：A组患者手术后48h内各观察点的VAS评分均明显低于B组（P均0.05）。A组患者术后48h内PICA按压总次数、镇痛药用量、镇痛期间总不良反应发生率，均明显少于B组（P0.05）。结论：术前给予布托啡诺行超前镇痛增强自控镇痛的效果，减少镇痛药用量及不良反应发生率，提高镇痛的质量与安全性。 　　[关键词]酒石酸布托啡诺；超前镇痛；隆乳术；临床观察 　　[中图分类号]R614.3 [文献标识码]A [文章编号]1008-6455（2014）21-1766-03 　　Abstract： Objective To evaluate the clinical effect of self-control intravenous anesthesia with preoperative give bhutto browns for patients with breast augmentation surgery. Methods From august 2013 to august 2014，120 patients with ASA classification I-II who required postoperative analgesia undergoing silicone breast implants using intravenous anesthesia were randomly divided into two groups，the preoperative medication group （group A） and the control group （group B），each group had 60 cases； Group A preoperative 30 min give tartrate bhuttos brown 20 ug/kg intravenous drip，group B preoperative to amount of saline intravenous drip. Results Within 48 hours after surgery，the VAS scores of each observation point，the total number of PICA press， the dosage of analgesic and the total incidence of adverse reactions during analgesia in patients of group A were significantly lower than that of group B （P0.05）. Conclusion Preoperative give brown bhuttos before analgesic can enhance self-control analgesia effect， reduce the dosage of analgesic， decrease the incidence of adverse reactions， improve the quality and safety of analgesia. 　　Key words： Butorphanol ；preemptive analgesic ；breast augmentation ；clinical observation 　　超前镇痛理论认为在伤害性刺激作用于机体之前采取一定的预防措施，可以防止中枢或周围神经过度的敏感化，减少初级及次级痛觉过敏、痛觉超敏和脊髓后角细胞受体的改变；其关键点在于有效地预防各种病理生理改变，最根本的原则是在疼痛发作之前预防，而不是在疼痛发作之后再处理疼痛。超前镇痛理论强调其镇痛的有效性和时间性[1]。酒石酸布托啡诺注射液是一种混合型阿片受体激动-拮抗药，用于术后镇痛具有依赖性及成瘾性较低、呼吸抑制轻、安全有效，且不良反应发生率低的特点[2]。 　　我院分别采用术前给予酒石酸布托啡诺注射液20μg/kg进行超前镇痛与对照给予生理盐水注射液进行对比观察；[3]本次研究旨在评价术前给与酒石酸布托啡诺注射液超前镇痛用于隆乳手术后患者静脉自控