- 期刊
An Evaluation of the Efficacy and Safety of Transnasal Butorphanol for Post-hemorrhoidectomy Pain Relief
鼻噴劑型Butorphanol止痛藥對痔瘡手術後止痛效果及安全性之評估
摘要
目的 痔瘡手術術後，傷口疼痛是病患常見的問題，適當的止痛是必須且重要的。我們比較鼻噴劑型Butorphanol止痛藥相對於肌肉注射Meperidine對於手術後的止痛效果和安全性，目的在增進術後疼痛控制的品質。 方法 從2006年10月到2007年10月，四十位病患接受痔瘡手術的病患，以隨機的方式分為兩組，每組二十人。Butorphanol組是術後每六小時口服Tolfenamic acid 100 mg及疼痛時每四小時間隔給予鼻噴劑型Butorphanol止痛藥一噴(1 mg)。Meperidine組是術後每六小時口服Tolfenamic acid 100 mg及疼痛時每四小時間隔給予肌肉注射Meperidine 止痛藥(0.8 mg/kg)。疼痛指數以VAS指數作為評估並紀錄藥物的不良反應包含嗜睡、暈眩、噁心及嘔吐，另外在病患出院前給予問卷詢問對藥物的止痛效果滿意度、副作用的反應及後續使用的意願。 結果 病患中21位為男性(52.5%)，19位為女性(47.5%)，在butorphanol組平均年齡為45.20歲，於meperidine組平均年齡為43.85歲，未給藥前疼痛指數在butorphanol組平均為7.12，於meperidine組平均為7.63，在接受止痛藥治療後，疼痛指數在butorphanol組平均下降1.97，於meperidine組平均下降2.68，並無統計學的差異(P=0.182)。在butorphanol組有較多嗜睡的副作用(30%)，但在副作用比較上，兩組並無統計學上的差異。另外，於問卷調查中，大多數病患滿意鼻噴劑型Butorphanol的止痛效果及方便性，並願意下次繼續接受鼻噴劑型Butorphanol止痛藥。 結論 鼻噴劑型Butorphanol在痔瘡術後的止痛效果和meperidine止痛藥相比，病患的滿意度相似，然而鼻噴劑型Butorphanol可以更方便的使用，以達到止痛及減少醫療資源的效果。
並列摘要
Purpose. Postoperative pain is the major patient complaint after hemorrhoidectomy, and adequate analgesia is imperative. Our purpose was to compare the analgesic properties and efficacy of transnasal butorphanol with meperidine. Methods. Forty patients who underwent hemorrhoidectomy were enrolled in the study from October 2006 to October 2007. They were divided randomly into two equal groups. Postoperatively, the butorphanol group received tolfenamic acid (100 mg) every 6 h and butorphanol nasal spray (1 mg) at least every 4 h if in pain. The meperidine group received tolfenamic acid (100 mg) every 6 h and intramuscular meperidine (0.8 mg/kg) at least every 4 h if in pain. Assessment of postoperative pain was made using a visual analogue scale (VAS) from 1 to 10. Medicinal adverse effects such as somnolence, dizziness, nausea and vomiting were recorded. Satisfaction with narcotic efficacy, desire to use this analgesia in the future, if required, and complaints were recorded using questionnaires before discharge. Results. Twenty-one (52.5%) patients were men and 19 (47.5%) were women. The mean age was 45.20 years in the butorphanol group compared with 43.85 years in the meperidine group. The mean VAS score was 7.12 in the butorphanol group compared with 7.63 in the meperidine group. After analgesia, the mean VAS score was reduced from baseline by 1.93 in the butorphanol group compared with 2.68 in the meperidine group after analgesia (P=0.182). The incidence of somnolence (30%) was higher in the butorphanol group. However, there were no statistically significant differences in adverse effects between the two groups. In addition, most of the patients were satisfied with the butorphanol nasal spray and wished to receive this analgesic in the future, if needed. Conclusion. Butorphanol nasal spray and meperidine were equally safe and effective for the relief of pain in patients undergoing hemorrhoidectomy. However, the butorphanol nasal spray offers more convenient and effective outpatient usage.
延伸閱讀
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