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題名 | Comparison of Epidural Butorphanol Plus Clonidine with Butorphanol Alone for Postoperative Pain Relief=硬脊膜外腔合併注射Butorphanol及Clonidine與單獨注射Butorphanol對術後止痛之比較 |
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作者姓名(中文) | 譚炳恒; 周安國; 彭至賢; 鍾漢軍; 李章成; 莫世湟; | 書刊名 | 麻醉學雜誌 |
卷期 | 35:2 1997.06[民86.06] |
頁次 | 頁91-96 |
分類號 | 416.5 |
關鍵詞 | 硬脊膜外; 成癮性麻醉劑; 甲型腎上腺素致活劑; Anesthesia; Epidural; Narcotics; Butorphanol; Adrenergic alpha-agonist; Clonidine; |
語文 | 英文(English) |
英文摘要 | 背景:本研究的目的在探討經由硬脊膜外腔合併使用butorphanol及clonidine時 , 所產生之臨床術後止痛效果,硬脊膜外給予 butorphanol 具有相當止痛療效,雖然止痛 效程比嗎啡短,但相對的副作用亦小,clonidine 曾經被證實使用在硬脊膜外注射具有止痛 效果,近來發現硬脊膜外給予 clonidine 及成癮性止痛劑,顯現 clonidine 具有加深成癮 性止痛劑止痛效用。方法:本研究選擇六十位接受腹部手術之病患在麻醉誘導之前,先放好 硬脊膜外導管,然後均施予全身麻醉,僅給吸入性麻醉劑,不給成癮性麻醉劑。術後當病人 抱怨痛時, 將他們依序分成兩組,第一組術後接受 0.5 mg butorphanol,第二組接受 0.5 mg butorphanol 加 75 μ g clonidine, 分別注射於硬脊膜外,所有病人均觀察其疼痛緩 解, 鎮靜, 血壓, 呼吸狀態和副作用 12 小時。 結果: 顯示第一組硬脊膜外腔給予 butorphanol 5 分鐘開始產生止痛作用,而在 20 至 30 分鐘時達到高峰, 並維持 4 至 6 小時。合併使用 butorphanol 和 clonidine 在開始的前 30 分鐘,疼痛緩解較優於單獨使 用 butorphanol,但並不具有統計之意義,兩組的止痛程度及作用時間皆非常相近,副作用 的發生率兩組亦非常相近,惟第二組會發生低血壓及長時間昏睡作用。結論:綜合以上研究 得知,硬脊膜外給予 clonidine 75 μ g 並無加強 butorphanol 痛效果,亦無減少副作用 ,此方法合併使用似乎並無助益於臨床上的使用。 for pain relief, sedation, vital signs, arterial blood gas studies and adverse effects for 12h. Results: Onset of pain relief with epidural butorphanol began at 5 min and peaked at 20-30 min with a duration of action lasting 4-6 h. The combination of butorphanol and clonidine had numerically superior pain relief than that of butorphanol for the first 30 min but it did not attain statistical significant difference. The duration of action with the combination group was similar to that of butorphanol alone. Incidence of adverse effects were similar in both groups except that hypotension and more pronounced sedation were observed in Group II. Conclusions: Our study showed that the addition of clonidine to epidural butorphanol did not enhance its analgesic effect in any significant manner nor did it reduce the adverse effects. This combination does not seem to offer any advantage for clinical use. |
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