布托啡诺在预防腹腔镜胆囊切除术瑞芬太尼麻醉后疼痛过敏中应用效果.docVIP

布托啡诺在预防腹腔镜胆囊切除术瑞芬太尼麻醉后疼痛过敏中应用效果 　　[摘要] 目的 探讨布托啡诺在预防腹腔镜胆囊切除术瑞芬太尼麻醉后疼痛过敏中的应用效果。 方法 选取2010年12月～2013年12月本院收治的腹腔镜胆囊切除术患者156例为研究对象，将其随机分成预防组（术前注射含布托啡诺的生理盐水）和常规组（单纯生理盐水），每组78例。比较两组的瑞芬太尼用量，手术时间，拔管时间，拔管后镇静评分以及手术0.5、4、8 h后的VAS评分。 结果 预防组的瑞芬太尼用量显著低于常规组，差异有统计学意义（P0.01）；预防组手术0.5、4、8 h后的VAS评分均明显低于常规组，差异有统计学意义（P0.01）。 结论 布托啡诺对于腹腔镜胆囊切除术瑞芬太尼麻醉后痛觉过敏的预防效果显著，是临床应用的理想选择之一。 　　[关键词] 布托啡诺；腹腔镜；胆囊切除术；瑞芬太尼 　　[中图分类号] R971+.2 [文献标识码] A [文章编号] 1674-4721（2015）06（c）-0051-03 　　[Abstract] Objective To discuss application effect of bhutto butorphanol preventing pain hypersensitivity after remifentanil anesthesia in laparoscopic cholecystectomy. Methods From December 2010 to December 2013，156 cases with laparoscopic cholecystectomy treated in our hospital were selected as the research objects，and they were randomly divided into prevention group （preoperative injection physiological saline containing bhutto butorphanol） and routne group （simple preoperative injection physiological saline），and thete wetre 78 cases in each group.The remifentanil usage dose，operation time，extubation time，sedation score after extubation，and VAS score after 0.5 h，4 h，8 h operation between two groups was compared respectively. Results The remifentanil usage dose in prevention group was significantly lower than that in routine group，and there was a statistical difference （P0.01）.VAS score after 0.5 h，4 h，8 h operation in prevention group was significantly lower than that in routine group respectively，and there was a statistical difference （P0.01）. Conclusion The effect of bhutto butorphanol preventing pain hypersensitivity after remifentanil anesthesia in laparoscopic cholecystectomy is remarkable，and it is one of the ideal choice for clinical application. 　　[Key words] Bhutto butorphanol；Laparoscope；Cholecystectomy；Remifentanil 　　临床试验证明[1]，痛觉过敏现象在停用瑞芬太尼后比较明显，大量的基础实验也证实了这一点，痛觉过敏现象会在很大程度上影响患者麻醉后的苏醒质量。资料显示[2-3]，布托啡诺的镇痛效果是哌替啶的6倍左右，在手术结束前给患者静脉注射布托啡诺可有效抑制瑞芬太尼的痛觉过敏现象。 　　在此背景下，为了进一步探讨布托啡诺在临床预防腹腔镜胆囊切除术瑞芬太尼麻醉痛觉过敏的临床实际影响，从而为相关的临