The effect comparison of different concentration dexmedetomidine with butorphanol on postoperative analgesia
10.3760/cma.j.issn.1673-4904.2013.21.009
- VernacularTitle:不同剂量右美托咪定复合布托啡诺在术后镇痛中的效果比较
- Author:
Yanfeng YU
;
Wenyang LIU
;
Yonghua QIN
- Publication Type:Journal Article
- Keywords:
Butorphanol;
Analgesia;
Dexmedetomidine
- From:
Chinese Journal of Postgraduates of Medicine
2013;36(21):29-32
- CountryChina
- Language:Chinese
-
Abstract:
Objective Through the effect comprison of analgesic calm and side-effect on postoperative analgesia under different concentration dexmedetomidine with butorphanol,to research the best concentration of dexmedetomidine on postoperative analgesia.Methods Ninety patients with lower abdominal surgery with general anesthesia,ASA Ⅰ-Ⅱ grade,were divided into 3 groups by random digits table:group A,group B and group C,each group with 30 cases.The group A received 0.2 μg/ (kg·h) dexmedetomidine.The group B received 0.3 μg/ (kg ·h) dexmedetomidine,both added 0.15 mg/kg butorphanol and 8 mg ondansetron.The group C only received 0.15 mg/kg butorphanol and 8 mg ondansetron.Applied patient controlled intravenous analgesia (PCIA) pump continuous infusion gave total 100 ml,background infusion 2 ml/h,patient controlled analgesia (PCA) 2 ml,lock time 30 min,analgesia was continued 48 h.Below were recorded at 2,6,12,24 and 48 h after the beginning of PCIA:analgesia VAS score,ramsay sedation scale (RSS),adverse reaction.The total number of button pressing of PCA and the consumption of patient controlled liqnid analgesia (PCLA) solution were also recorded.Results There was no statistically significant difference in VAS score after each time point between group A and group B (P＞ 0.05).The VAS scores after each time point in group A and group B were significantly lower than those in group C [(2.7 ±0.8),(2.6 ± 0.8) scores vs.(3.2 ± 0.9) scores; (1.8 ± 0.6),(1.7 ± 0.6) scores vs.(2.5 ± 0.6) scores; (1.0 ±0.6),(0.9 ±0.7) scores vs.(1.8 ±0.6) scores; (1.0 ±0.5),(0.8 ±0.5) scores vs.(1.4 ±0.5) scores; (0.7 ±0.5),(0.7 ±0.4) scores vs.(1.0 ±0.5) scores,P ＜0.05].There was no statistically significant difference in RSS score among 3 groups (P ＞ 0.05).The RSS scores after 6,12,24 and 48 h in group A and group B were significantly higher than those in group C [(2.6 ±0.5),(3.5 ±0.6) scores vs.(2.0 ±0.3) scores; (2.9 ± 0.6),(3.8 ± 1.2) scores vs.(2.4 ± 0.3) scores; (2.8 ± 0.7),(3.9 ± 0.7) scores vs.(2.5 ± 0.4)scores; (2.8 ± 0.6),(3.9 ± 0.6) scores vs.(2.5 ± 0.5) scores,P ＜ 0.05],group A was significantly higher than those in group B (P＜ 0.05).There was no statistically significant difference in rate of hypoxemia among 3 groups (P ＞ 0.05).The rates of nausea and vomit,deliration in group A and group B were significantly lower than those in group C [3.3％(1/30),0 vs.10.0％(3/30) ;0,0 vs.10.0％(3/30),P＜ 0.05].The rates of hypotension and bradycardia in group B were significantly lower than those in group A and group C[16.7％ (5/30) vs.3.3％(1/30),0;20.0％(6/30) vs.3.3％(1/30),0,P＜ 0.05].The total number of button pressing of PCA 24 h and the consumption of PCLA solution in group C were significantly higher than those in group A and group B [(13.9 ±2.4) times vs.(9.7 ±2.2),(7.4 ± 1.5) times; (60.9 ± 1.8) ml vs.(54.5 ± 1.2),(50.7 ± 0.7) ml,P ＜ 0.05].Conclusion Concentration 0.2 μ g/(kg· h) dexmedetomidine with butorphanol has better effects on postoperative analgesia and calm,less side-effect.
