不同剂量丁丙诺啡对乳腺癌术后镇痛效果比较.docVIP

不同剂量丁丙诺啡对乳腺癌术后镇痛效果比较 　【摘要】 目的比较两种剂量丁丙诺啡对乳腺癌术后的镇痛效果。方法选择全麻择期乳腺癌根治术成年患者120例，ASAⅠ~Ⅱ级，随机分为两组，A组60例术后静脉输注丁丙诺啡0.1 μg/（kg·h）；B组60例术后静脉输注丁丙诺啡0.3 μg/（kg·h）。采用视觉模拟评分法（VAS评分）评价术后6、12、24和48 h 的疼痛程度， 于各时点行镇静评分及PrinceHenry评分， 监测呼吸频率(RR)，记录不良反应的发生情况。结果两组年龄、体重、ASA分级、并发症比较差异均无统计学意义(Pgt; 0.05)。与A组比较，B组镇痛效果满意，VAS评分、镇静评分、PrinceHenry评分、RR及恶心发生率均有统计学差异(Plt;0.05)。结论静脉输注丁丙诺啡0.3 μg/（kg·h）可有效缓解乳腺癌手术后患者疼痛， 且不良反应少。 【关键词】 丁丙诺啡 镇痛 乳腺癌 手术后 　　　Abstract： ObjectiveTo study the effect of buprenorphine on postoperative analgesia in breast cancer patients. MethodsA total of 120 patients with breast cancer of ASA I or II undergoing selective operation under general anesthesia were randomly divided into two groups (n=60/group). Group A was administered with continuously intravenous buprenorphine at 0.1 μg/kg·h-1 after operation,and Group B with continuously intravenous buprenorphine at 0.3 μg/kg·h-1 after operation. The intensity of pain was assessed using VAS scoring at 6, 12, 24 and 48 hours after operation, as well as side effects and respiratory rate (RR). ResultsThere were no significancely differences in age, body weight, ASA class and complication between the two groups (Pgt;0.05). Group B achieved a better postoperative analgesic effect than group A. There existed significancely differences in VAS scoring, side effects and RR after operation (Plt;0.05).ConclusionContinuously intravenou infusion of buprenorphine at 0.3 μg/kg·h-1 can provide an effective postoperative analgesia without respiratory depression and with few side effects. 　　Key words： buprenorphine; analgesia; breast cancer; postoperative 　　手术后镇痛是临床医师极为关注的问题， 因为疼痛会给患者造成极大痛苦， 影响康复。良好的术后镇痛可抑制机体应激反应， 有利于减少术后并发症， 促进伤口愈合， 加快患者恢复。用于患者术后镇痛的方法和药物很多。在全麻乳腺癌根治术患者中，我们比较了两种剂量丁丙诺啡术后的镇痛效果，现将结果报告如下。 　　1资料与方法 　　11一般资料 　　选择我院2006年6月—2007年10月全麻择期乳腺癌根治术成年患者120例，阿片类药物过敏、长期使用阿片类或非阿片类镇痛药、肝肾功能异常、肝、肾、胰腺切除术患者排除本试验。随机均分为两组。A组60例，平均年龄(51.1±3.6) 岁， 平均体重(53±8.2) kg，ASA Ⅰ28例，ASA Ⅱ32例。B组60例，平均年龄(51.7±4.5) 岁， 平均体重(54.1±7.3) kg，ASAⅠ31例，ASAⅡ29例。 　　12给药方案 　　麻醉前30 mi