CAJ | 학술논문

目的：观察酒石酸布托啡诺复合氟比诺芬酯用于骨科病人术后静脉镇痛的有效性及安全性。方法选取我院2011年6月至2013年8月ASAⅠ～Ⅱ级择期进行髋关节手术患者120例，随机分成治疗组和对照组各60例。两组在麻醉下完成手术后施行静脉镇痛，治疗组（ Z）：手术结束前30 min缓慢静注酒石酸布托啡诺1 mg＋氟比诺芬酯50 mg，术毕以酒石酸布托啡诺0．1 mg/kg＋氟比诺芬酯2 mg/kg用0．9％生理盐水稀释至100 ml接镇痛泵持续静脉注射；对照组（ D）：手术结束前30 min缓慢静注酒石酸布托啡诺1 mg＋芬太尼0．1 mg，术毕以酒石酸布托啡诺0．1 mg/kg＋芬太尼0．01 mg/kg用0．9％生理盐水稀释至100ml接镇痛泵持续静脉注射。记录术后6、12、24、48 h患者VAS镇痛评分及不良反应发生情况。结果两组患者比较，术后6～48VAS镇痛评分统计学无显著性差异（P＞0．05）；术后不良反应如恶心、呼吸抑制、嗜睡、皮肤瘙痒等治疗组明显低于对照组（P＜0．01）。结论酒石酸布托啡诺复合氟比诺芬酯用于髋关节术后镇痛其疗效确切，并可减少不良反应的发生，对临床推广有重要的意义。
목적：관찰주석산포탁배낙복합불비낙분지용우골과병인술후정맥진통적유효성급안전성。방법선취아원2011년6월지2013년8월ASAⅠ～Ⅱ급택기진행관관절수술환자120례，수궤분성치료조화대조조각60례。량조재마취하완성수술후시행정맥진통，치료조（ Z）：수술결속전30 min완만정주주석산포탁배낙1 mg＋불비낙분지50 mg，술필이주석산포탁배낙0．1 mg/kg＋불비낙분지2 mg/kg용0．9％생리염수희석지100 ml접진통빙지속정맥주사；대조조（ D）：수술결속전30 min완만정주주석산포탁배낙1 mg＋분태니0．1 mg，술필이주석산포탁배낙0．1 mg/kg＋분태니0．01 mg/kg용0．9％생리염수희석지100ml접진통빙지속정맥주사。기록술후6、12、24、48 h환자VAS진통평분급불량반응발생정황。결과량조환자비교，술후6～48VAS진통평분통계학무현저성차이（P＞0．05）；술후불량반응여악심、호흡억제、기수、피부소양등치료조명현저우대조조（P＜0．01）。결론주석산포탁배낙복합불비낙분지용우관관절술후진통기료효학절，병가감소불량반응적발생，대림상추엄유중요적의의。
Objective To observe the effectiveness and safety of butorphanol tartrate combined with flurbiprofen esterfor postoperative analgesia in orthopedic patients .Methods Patients ( ASA Ⅰ/Ⅱ, n=120 ) received hip joint surgery in our hospital during June 2011and August 2013were divided into treatment group and control grouprandomly , 60 patients in each group .Patients in treatment group ( Z ) were intravenous given butorphanol tartrate (1mg) and flurbiprofen ester (50mg) 30min before the surgery was complete , and they were given butorphanol tartrate (0.1mg/kg) and flurbiprofen ester (2mg/kg) postoperative.Patients in control group ( D) received butorphanol tartrate (1mg) and fentanyl (0.1mg) 30min before the surgery slow was complete , and received butorphanol tartrate at the dose of 0.1mg/kg and 0.01mg/kg fentanyl postoperative .Postoperative VAS pain scoresof patients were recorded at 6,12,24,48hours after surgery and still the incidence of adverse reactions . Results Differences of postoperative VASpain score between the two groups at the time point 6, 12, 24, 48 present nostatistically significant ( P >0.05 );Postoperative adverse reactions ( such as nausea, respiratory depression,lethargy,pruritus) in treatment group was significantly lower than the control group ( P <0.01). Conclusions Butorphanol tartrate combined with fentanyl was effective for postoperative analgesia in hip joint surgery, could reduce the incidence of adverse reactions , thus it have clinical significance .