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1、布托啡諾超前鎮(zhèn)痛對肋間神經(jīng)阻滯效果的影響【摘要】目的評價(jià)布托啡諾超前鎮(zhèn)痛對羅哌卡因肋間神經(jīng)阻滯效果的影響。方法選擇40例擬在肋間神經(jīng)阻滯下行乳房病損切除術(shù)的女性患者，采用雙盲法隨機(jī)分成試驗(yàn)組(A組)和對照組(B組)，每組各20例：A組患者于肋間神經(jīng)阻滯前5min靜脈推注布托啡諾20μg／kg，B組于肋間神經(jīng)阻滯前5min靜脈推注安慰劑(生理鹽水)。兩組均施行羅哌卡因肋間神經(jīng)阻滯。對術(shù)中麻醉滿意程度進(jìn)行評價(jià)，記錄麻醉起效時(shí)間、麻醉維持時(shí)間及惡心嘔吐等不良反應(yīng)發(fā)生率，分別于術(shù)后1、4、12、24h采用“視覺模擬評分法（VAS）”進(jìn)行疼痛評分。結(jié)果術(shù)中麻醉滿意程
2、度A組優(yōu)于B組，術(shù)后4、12h時(shí)疼痛評分A組顯著低于B組(P<0．05)，麻醉維持時(shí)間A組明顯長于B組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0．01）。結(jié)論術(shù)前靜脈推注布托啡諾具有一定的超前鎮(zhèn)痛效果，能夠增強(qiáng)羅哌卡因肋間神經(jīng)阻滯效果，延長術(shù)后鎮(zhèn)痛時(shí)間，不良反應(yīng)少，值得臨床采用。 【關(guān)鍵詞】布托啡諾；超前鎮(zhèn)痛；肋間神經(jīng)阻滯；羅哌卡因 【Abstract】ObjectiveToevaluatetheclinicalefectsofButorphanolpreempitiveanalgesiaonintercostalnerveblockwit
3、hropivacaine．MethodsApplingdoubleblindmethod，40adultmalepatientsundergoingbreastlesionresectionoperationonintercostalnerveblockweredividedrandomlyinto7testgroup(groupA)andcontrolgroup(groupB)with20caseseach.Everygroupreceivedintercostalnerveblockwithropivacaine．GroupA(testgroup)in
4、travenouslyinjectedthepatientwithbutorphanol20μg／kgat5minutesbeforeintercostalnerveblock.GroupB(controlgroup)intravenousinjectedthepatientwithplacebo(physiologicalsaline)at5minbeforeintercostalnerveblock.Thedegreeofintraoperativeanesthesiasatisfactionwasevaluated．Theonsettimeofane
5、sthesia,thedurationtimeofnerveblockade，theadversereaction(egnauseaandvomiting)andVAS(thevisualanaloguescale)scoresat1，4，12，24hoursafteroperativewererecorded．ResultsThedegreeofintraoperativeanesthesiasatisfactioningroupAwasbetterthanthatingroupB(P<0．05)，Thedurationofnerveblockad
6、eingroupAwasobviouslylongerthanthatingroupB(P<0．01)．ThescoresofVASat4、12hpostoperativeingroupBwashigherthanthatingroupA(P<0．05)．ConclusionIntravenouslyinjectingbutorphanolbeforeoperativehavetheefectofpreempitiveanalgesia．Itcanpotentiatetheefectsofintercostalnerveblockwithrop
7、ivacaineandprolongthetimeofpostoperativeanalgesiaandlittleadversereaction，deservetheclinicadoption．7 【Keywords】Butorphanol；Preempitiveanalgesia；Intercostalnerveblock；Ropivacaine 超前鎮(zhèn)痛是傷害性刺激作用于機(jī)體之前采取一定的措施，防止神經(jīng)中樞敏感化，減少和消除傷害引起的疼痛[1]。布托啡諾是混合型阿片受體激動(dòng)-拮抗劑，其鎮(zhèn)痛效應(yīng)強(qiáng)，鎮(zhèn)痛時(shí)間久，呼吸抑制和成癮性發(fā)生率較低。本
8、研究旨在觀察布托啡諾超前鎮(zhèn)痛對肋間神經(jīng)阻滯效果、麻醉維持時(shí)間、術(shù)后
