Comparison between Butorphanol and Fentanyl Used for Patient-controlled Intravenous Analgesia after Abdominal Surgery_West China Medical Journal

Authors：

LUO Xiongying , LI Lingling , CHEN Tao , TAO Yanzhi , LEI Da.

Department of Anesthesia, Sichuan Hospital of Integrated Traditional and Western Medicine, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

Keywords：

酒石酸布托啡諾; 舒芬太尼; 自控靜脈鎮痛; 不良反應

DOI：

10.7507/1002-0179.20130272

Video：

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目的　通過對腹部手術后自控靜脈鎮痛（PCIA）不同藥物配方的研究，探討酒石酸布托啡諾與舒芬太尼用于術后PCIA臨床效果。方法　將2012年2月－8月收治的60例麻醉分級為Ⅰ～Ⅲ級需術后鎮痛的腹部手術患者（均無心、肺、肝、腎、腦、內分泌疾病及過敏史）隨機分成兩組：酒石酸布托啡諾組（N組，n=30），舒芬太尼組（S組，n=30）。觀察鎮痛效果和不良反應發生率。結果　兩組鎮痛效果差異無統計學意義（P＞0.05），不良反應（包括惡心、嘔吐、頭暈、嗜睡、皮膚瘙癢、呼吸抑制、尿潴留等），N組發生率均低于S組（P＜0.05）。結論　酒石酸布托啡諾用于PCIA安全、有效，不良反應少。

Citation： LUO Xiongying,LI Lingling,CHEN Tao,TAO Yanzhi,LEI Da.. Comparison between Butorphanol and Fentanyl Used for Patient-controlled Intravenous Analgesia after Abdominal Surgery. West China Medical Journal, 2013, 28(6): 868-870. doi: 10.7507/1002-0179.20130272 Copy

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1. 　畢娜, 姚梅芳, 徐美英. 術后疼痛及止痛的進展[J]. 國外醫學護理學分冊, 1999, 18(5): 211-214.
2. 　連慶泉, 李軍. 圍術期疼痛治療的新理念[J]. 現代實用醫學, 2005, 17(2): 116-118.
3. 　耿莉華, 宋雁賓. 外科手術后疼痛的控制進展[J]. 實用護理雜志, 1999, 15(9): 12.
4. 　劉俊杰, 趙俊, 譯. 現代麻醉學[M]. 2版. 北京: 人民衛生出版社, 1997: 1431.
5. 　蔣宗濱, 譚冠先, 胡振快, 等. 手術病人對術后鎮痛認識程度的調查[J]. 中國疼痛醫學雜志, 1998, 4(4): 197-201.
6. 　金昔陸. μ阿片受體激動劑舒芬太尼的藥理作用與應用[J]. 中國現代應用藥學雜志, 1999, 16(1): 57-62.
7. 　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.
8. 　Butelman ER, Winger G, Zernig G, et al. Butorphanol: characterization of agonist and antagonist effects in rhesus monkeys[J]. J Pharmacol Exp Ther, 1995, 272(2): 845-853.
9. 　Preston KL, Bigelow GE, Liebson IA. Discrimination of butorphanol and nalbuphine in opioid-dependent humans[J]. Pharmacol Biochem Behav, 1990, 37(3): 511-522.
10. 　Vogelsang J, Butorphanoltartrate HS. (stado1):a review[J]. J Post AnesthNuts, 1991, 6(2): 129-135.
11. 　戴體俊, 喻田, 譯. 麻醉藥理學[M]. 3版. 北京: 人民衛生出版社, 2011: 53.
12. 　杭燕南. 當代麻醉與復蘇[M]. 上海: 上海科技出版社, 1994: 115-120.
13. 　李慧祿, 王少超, 孫梅杰. 布托啡諾剖宮產術后硬膜外鎮痛效果[J]. 臨床麻醉學雜志, 2006, 22(6): 473.
14. 　Chang KJ, 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.
15. 　Garner 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.
16. 　Gilman AG, Goodman LS, Gilman A, et al. Pharmacological basis of therapeutics[M]. 8th ed. 1990: 508-513.
17. 　Bowdle TA, Greichen SL, Bjurstrom RL, et al. Butorphanol improves CO2 response and ventilation after fentanyl anesthesia[J]. Anesth Analg, 1987, 66(6): 517-522.
18. 　何蕾, 張小洺, 徐亮. 酒石酸布托啡諾與芬太尼聯合用于婦科患者術后靜脈自控鎮痛的臨床研究[J]. 華西醫學, 2012, 27(3): 63-66.

West China Medical Journal

Comparison between Butorphanol and Fentanyl Used for Patient-controlled Intravenous Analgesia after Abdominal Surgery

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