[连续硬膜外给予丁丙诺啡用于开胸术后疼痛缓解]

[Continuous epidural buprenorphine for postoperative pain relief after thoracotomy].

作者信息

Hirabayashi Y, Mitsuhata H, Shimizu R, Ikeno S, Togashi H, Saitoh J, Saitoh K, Fukuda H

机构信息

Department of Anesthesiology, Jichi Medical School, Tochigi.

出版信息

Masui. 1995 Apr;44(4):489-92.

PMID:7776510

Abstract

To evaluate postoperative analgesia and side effects of epidural buprenorphine, 60 patients after thoracotomy were divided into 6 groups. All patients received a bolus epidural administration of buprenorphine 0.1 mg in 8 ml of 0.25% bupivacaine. Following this epidural bolus, 10 patients in each group were given 0.25% bupivacaine alone (group A), buprenorphine 5 micrograms in 1 ml of 0.25% bupivacaine (group B), buprenorphine 8 micrograms in 1 ml of 0.25% bupivacaine (group C), buprenorphine 12 micrograms in 1 ml of 0.25% bupivacaine (group D), buprenorphine 15 micrograms in 1 ml of 0.25% bupivacaine (group E) or buprenorphine 18 micrograms in 1 ml of 0.25% bupivacaine (group F) with a portable disposable device at a rate of 1 ml.h-1 for 48 h. The percentages of patients who did not need additional narcotics for the first 24 hours postoperatively in group A, B, C, D, E, and F were 20%, 40%, 30%, 50%, 60%, and 70%, respectively. Those for the second 24 hours postoperatively in each group were 40%, 50%, 70%, 60%, 90%, and 90%, respectively. No significant difference in the incidence of side-effect was found among 6 groups. We concluded that optimal epidural doses of buprenorphine for post-thoracotomy pain relief are 15 and 18 micrograms.h-1 in the first and second 24 hours postoperatively, respectively.

摘要

为评估硬膜外注射丁丙诺啡的术后镇痛效果及副作用，将60例开胸术后患者分为6组。所有患者均接受硬膜外注射含0.1 mg丁丙诺啡的8 ml 0.25%布比卡因。硬膜外推注后，每组10例患者分别单独给予0.25%布比卡因（A组）、含5微克丁丙诺啡的1 ml 0.25%布比卡因（B组）、含8微克丁丙诺啡的1 ml 0.25%布比卡因（C组）、含12微克丁丙诺啡的1 ml 0.25%布比卡因（D组）、含15微克丁丙诺啡的1 ml 0.25%布比卡因（E组）或含18微克丁丙诺啡的1 ml 0.25%布比卡因（F组），使用便携式一次性装置以1 ml·h⁻¹的速度持续输注48小时。A、B、C、D、E和F组术后前24小时不需要额外使用麻醉剂的患者百分比分别为20%、40%、30%、50%、60%和70%。每组术后第二个24小时的相应百分比分别为40%、50%、70%、60%、90%和90%。6组间副作用发生率无显著差异。我们得出结论，开胸术后镇痛的最佳硬膜外丁丙诺啡剂量在术后第一个24小时和第二个24小时分别为15微克·h⁻¹和18微克·h⁻¹。