布托啡诺复和双氯芬酸钠在瑞芬太尼麻醉下行腹腔镜宫外孕治疗患者术后镇痛中的应用

目的探讨布托啡诺和双氯芬酸钠在瑞芬太尼复合丙泊酚全凭静脉麻醉下行腹腔镜宫外孕治疗患者术后疼痛管理中的作用。方法择期行腹腔镜宫外孕病灶清除术患者120例，ASAI级，年龄19～36岁，随机分为布托啡诺（B）组、双氯芬酸钠（D）组和布托啡诺复合双氯芬酸钠（BD）组，各40例。B组患者于手术结束前20min静脉给予布托啡诺0．02mg／kg；D组患者于气管插管后取50mg双氯芬酸钠栓塞入肛门；BD组患者于气管插管后取50mg双氯芬酸钠栓塞人肛门，并于手术结束前20min静脉给予布托啡诺0．02mg／kg。术毕拔管及术后2、4、8、12、24h采用视觉模拟评分（VAS）进行镇痛评分。结果B组和BD组患者术毕拔管后、术后2hVAS评分低于D组患者，但无统计学意义（P〉0．05）；BD组术后4、8、12、24hVAtS评分明显低于B和D组患者（P〈0．05）。结论防御性应用布托啡诺复合双氯芬酸钠栓可显著缓解腹腔镜宫外孕手术患者术后的疼痛。

Butorphanol and Diclofenac for preventive analgesia on postoperative pain management in patients undergoing laparoscopic treatment of ectopic pregnancy

Objective To evaluate the roles of of butovphanol and diclofenae in the postoperative pain manage- ment in patients undergoing laparoseopie treatment of ectopie pregnancy. Methods 120 patients scheduled for la- paroscopie treatment of eetopic pregnancy, ASA I grade, 19 to 36 year old were randomized into three groups with 40 patients each： butorphanol （B） group, dielofenae （D） group, butorphanol and dielofenae （BD） group. The pa- tients of B group were injected in vein butorphanol 0.02 mg/kg at 30rain before the end of operation; The patients of D group received a 50 mg rectal diclofenac suppository while on the operating table after tracheal intubation; The patients of BD group received a 50 mg rectal diclofenac suppository while on the operating table after tracheal intubation and in vein butorphanol 0.02 mg/kg at 30min before the end of operation. Pain was evaluated by visual analogue scale（VAS） at 0,2,4,8,12 and 24h postoperatively. Results The scores in VAS in the BD group were lower than those in the B and D groups at 8,12and24h postoperatively（ P 〈 0.05）. Conclusion Intravenous bu- torphanol and rectal dielofenac suppository for preventive analgesia in postoperative pain relief of patients undergo- ing laparoseopie treatment of ectopie pregnancy is significant.