CAJ | 학술논문

目的：探讨布托啡诺预防开胸手术患者麻醉苏醒期躁动的有效性及安全性。方法选取2011年3月~2014年1月在本院行开胸手术的150例患者作为研究对象，随机分为A组、B组和C组，各50例，分别于术毕前30 min给予帕瑞昔布钠(A组)、芬太尼(B组)、布托啡诺(C组)，以预防术后苏醒期躁动。比较3组术后10 min的视觉模拟评分(VAS)，在麻醉恢复室的苏醒时间、拔管时间、Ramsay镇静评分、躁动及不良反应发生率。结果 B组的苏醒时间显著长于C组和A组，差异有统计学意义(P<0.05)。 B组的呼吸抑制及延迟呼吸抑制发生率显著高于A组和C组，差异有统计学意义(P<0.05)。3组的恶心呕吐、舌后坠、头昏嗜睡发生率比较，差异无统计学意义(P跃0.05)。A组的VAS评分显著高于B组和C组，差异有统计学意义(P<0.05)。3组的Ramsay评分及躁动发生率比较，差异无统计学意义(P跃0.05)。结论开胸手术术毕前静脉注射常量布托啡诺能够有效预防苏醒期躁动，安全性较高，值得临床推广应用。
목적：탐토포탁배낙예방개흉수술환자마취소성기조동적유효성급안전성。방법선취2011년3월~2014년1월재본원행개흉수술적150례환자작위연구대상，수궤분위A조、B조화C조，각50례，분별우술필전30 min급여파서석포납(A조)、분태니(B조)、포탁배낙(C조)，이예방술후소성기조동。비교3조술후10 min적시각모의평분(VAS)，재마취회복실적소성시간、발관시간、Ramsay진정평분、조동급불량반응발생솔。결과 B조적소성시간현저장우C조화A조，차이유통계학의의(P<0.05)。 B조적호흡억제급연지호흡억제발생솔현저고우A조화C조，차이유통계학의의(P<0.05)。3조적악심구토、설후추、두혼기수발생솔비교，차이무통계학의의(P약0.05)。A조적VAS평분현저고우B조화C조，차이유통계학의의(P<0.05)。3조적Ramsay평분급조동발생솔비교，차이무통계학의의(P약0.05)。결론개흉수술술필전정맥주사상량포탁배낙능구유효예방소성기조동，안전성교고，치득림상추엄응용。
Objective To explore the effectiveness and safety of butorphanol in the prevention of agitation during anes-thesia recovery in patients undergoing thoracotomy. Methods 150 patients undergone thoracotomy from March 2011 to January 2014 in our hospital were selected and randomly divided into group A,group B and group C,50 cases in each group.In order to prevent agitation during anesthesia recovery,parecoxib sodium (group A),fentanyl (group B) and butor-phanol (group C) before surgeries at 30 minutes was provided respectively.The visual analogue score (VAS) after surgery at 10 minutes,wakening time in postanesthesia care unit,extubation time,Ramsay sedation score,the incidence rate of agitation and other adverse reaction among three groups was compared. Results The awakening time of group B was longer than that of group A and group B,with significant difference (P<0.05).The incidence rate of respiratory de-pression and delayed inhibition in group B was higher than that in group A and group B,with significant difference (P<0.05).Compared with the incidence rate of nausea and vomiting,glossoptosis,dizziness and drowsiness,there was no sta-tistical difference in group A,group B or group C (P>0.05).The score of VAS in group A was higher than that in group B and group C,with significant difference (P<0.05).Compared with the score of Ramsay sedation and the incidence rate of agitation,there was no statistical difference in group A,group B and group C (P>0.05). Conclusion Intravenous injection of normal dosage of butorphanol can effectively prevent agitation during anesthesia recovery before the ending of thora-cotomy with a higher security,it is worthy of clinical promotion and application.