布托啡诺对中老年焦虑患者术中镇静情况及术后睡眠质量的影响  

Influences of butorphanol on intraoperative sedation and postoperative sleep quality in middle-aged and elderly patients with anxiety

作　　者：宋比佳 朱俊超[1] SONG Bijia;ZHU Junchao(Department of Anesthesiology,Shengjing Hospital Affiliated to China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院麻醉科

出　　处：《中华实用诊断与治疗杂志》2019年第6期601-603,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：辽宁省自然科学基金(20102282)

摘　　要：目的探讨布托啡诺对中老年焦虑患者术中镇静情况及术后睡眠质量的影响。方法行骨科下肢手术的中老年焦虑患者40例,随机分为布托啡诺镇静组20例和对照组20例;术前5 min,布托啡诺镇静组患者静脉滴注布托啡诺15μg/kg,以7.5μg/(kg·h)静脉泵注至手术结束,对照组以等量生理盐水静脉滴注及泵注至手术结束。观察并记录2组患者麻醉前(T0)、注药后5 min(T1)、10 min(T2)、15 min(T3)、30 min(T4)、60 min(T5)时平均动脉压、心率、脉搏血氧饱和度和Ramsay镇静评分。术前1 d及术后1、2、3、7 d采用阿森斯失眠量表评估2组患者睡眠情况。结果布托啡诺镇静组术后1、2、3 d阿森斯失眠量表评分[(5.7±0.9)、(1.6±0.5)、(1.4±0.5)分]低于对照组[(7.6±1.2)、(2.3±0.8)、(1.9±0.5)分](P<0.05),术前1 d和术后7 d[(8.0±1.9)、(1.2±0.4)分]与对照组[(8.4±1.7)、(1.4±0.5)分]比较差异无统计学意义(P>0.05);T0时2组患者平均动脉压、心率、脉搏血氧饱和度和Ramsay镇静评分比较差异均无统计学意义(P>0.05),T1~T5时布托啡诺镇静组平均动脉压、心率低于对照组(P<0.05),Ramsay镇静评分高于对照组(P<0.05),脉搏血氧饱和度与对照组比较差异无统计学意义(P>0.05);布托啡诺镇静组术后24 h应用镇痛药比率(20%)低于对照组(50%)(P<0.05),不良反应发生率(35.0%)与对照组(25.0%)比较差异无统计学意义(P>0.05)。结论中老年焦虑患者骨科下肢手术术中应用布托啡诺可起有效镇静、镇痛作用,术中血流动力学稳定,不良反应少,且可改善患者术后睡眠质量。Objective To observe the influences of butorphanol on intraoperative sedation and postoperative sleep quality in middle-aged and elderly patients with anxiety. Methods Forty middle-aged and elderly patients with anxiety undergoing lower limb orthopedic surgery were randomly divided into butorphanol sedation group(n=20) and control group(n=20). Butorphanol sedation group received intravenous infusion of 15 μg/kg butorphanol 5 min before surgery, followed by 7.5 μg/(kg·h) intravenous pump till the end of surgery, while control group received intravenous infusion and pump of equivalent volume of normal saline till the end of surgery. The mean arterial pressure, heart rate, pulse oxygen saturation and Ramsay sedative score were recorded at the time points of before anesthesia(T0), and 5 min(T1), 10 min(T2), 15 min(T3), 30 min(T4) and 60 min(T5) after intravenous infusion. The sleep quality was assessed by Athens Insomnia Scale 1 day before surgery, and by day 1, 2, 3 and 7 after surgery in two groups. Results The Athens Insomnia Scale scores were significantly lower in butorphanol sedation group by day 1, 2 and 3 after surgery(5.7±0.9, 1.6±0.5, 1.4±0.5) than those in control group(7.6±1.2, 2.3±0.8, 1.9±0.5)(P<0.05), and showed no significant differences between butorphanol sedation group(8.0±1.9, 1.2±0.4) and control group(8.4±1.7, 1.4±0.5) 1 day before surgery and by day 7 after surgery(P<0.05). There were no significant differences in mean arterial pressure, heart rate, Ramsay sedative score and pulse oxygen saturation at T0 between two groups(P>0.05). The mean arterial pressures and heart rates were significantly lower and Ramsay sedative score significantly higher at T1-T5 in butorphanol sedation group than those in control group(P<0.05), and pulse oxygen saturation showed no significant difference at T1-T5 between two groups(P>0.05). The proportion of analgesics used in 24 h after surgery was significantly lower in butorphanol sedation group(20%) than that in control group(50%)(P<0.05), and the inci

关 键 词：布托啡诺 焦虑 镇静 睡眠 

分 类 号：R614[医药卫生—麻醉学]