布托啡诺预处理在臂丛神经阻滞复合全身麻醉肩关节镜手术中的作用分析  

Effects of Butorphanol Preconditioning on Brachial Plexus Block Combined with General Anesthesia in Shoulder Surgery

作　　者：赵彦春[1] 张丽[1] 赵丽艳[1] 郭永娟[1] ZHAO Yan-chun;ZHANG Li;ZHAO Li-yan;GUO Yong-juan(Department of Anesthesiology,Luoyang Orthopedic Hospital,Luoyang 471013,China)

机构地区：[1]河南省洛阳正骨医院麻醉科,洛阳471013

出　　处：《中国合理用药探索》2022年第3期40-45,共6页Chinese Journal of Rational Drug Use

基　　金：河南省中医药科学研究专项课题(2019ZY2090)。

摘　　要：目的:探讨布托啡诺预处理对臂丛神经阻滞复合全身麻醉肩关节镜手术患者的作用。方法:回顾性分析本院2019年1月~2021年4月行臂丛神经阻滞复合全身麻醉肩关节镜手术的102例患者为研究对象,根据布托啡诺预处理情况分为预处理1组(n=35,全麻诱导前予以1mg布托啡诺预处理)、预处理2组(n=25,全麻诱导前予以2mg布托啡诺预处理)和对照组(n=42)。3组均行罗哌卡因臂丛神经阻滞复合全身麻醉,并接受肩关节镜手术治疗。统计比较3组术后拔管时间、术后苏醒时间、术后镇痛药物用量、术后不良反应发生率;比较3组布托啡诺用药前(T_(1))、麻醉诱导前(T_(2))、麻醉诱导1min(T_(3))的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2))等血流动力学指标变化。采用视觉疼痛模拟评分(VAS)评价两组术后2、4、8、12h和24h的疼痛程度。结果:对照组术后拔管时间、术后苏醒时间均长于预处理1组和2组,术后镇痛药物用量高于预处理1组和2组(P<0.05);预处理1组和2组的术后拔管时间、术后苏醒时间和术后镇痛药物用量比较无统计学差异(P>0.05)。对照组T_(2)、T_(3)的HR和MAP均高于预处理1组和2组(P<0.05);预处理1组和2组各时间段的HR和MAP比较无统计学差异(P>0.05);3组各时间段SpO_(2)比较无统计学差异(P>0.05)。对照组术后8、12h和24h的VAS评分均低于预处理1组和2组(P<0.05);预处理1组和2组各时间段的VAS评分比较无统计学差异(P>0.05)。3组术后不良反应发生率比较无统计学差异(P>0.05)。结论:布托啡诺预处理可提高臂丛神经阻滞复合全身麻醉肩关节镜手术的镇痛效果及血流动力学水平,且1mg和2mg布托啡诺预处理效果和安全性无统计学差异。Objective:To investigate the effects of butorphanol preconditioning on brachial plexus block combined with general anesthesia in shoulder surgery.Methods:The clinical data of 102 patients who underwent brachial plexus block combined with general anesthesia from January 2019 to April 2021 in our hospital were retrospectively analyzed.According to the application of butorphanol pretreatment,they were divided into pretreatment 1 group(n=35,pretreatment of 1 mg of butorphanol before induced general anesthesia),pretreatment 2 groups(n=25,pretreatment of 2 mg of butorphanol before induced general anesthesia)and control group(n=42).All patients in the three groups received ropivacaine brachial plexus block combined with general anesthesia and shoulder surgery.The postoperative extubation time,postoperative recovery time,postoperative analgesic dosage and the rate of adverse reactions of the three groups were statistically compared.The heart rate(HR),mean arterial pressure(MAP)and blood oxygen saturation(SpO_(2))and other hemodynamic indexes of the three groups before butorphanol using(T_(1)),before anesthesia induction(T_(2)),and 1 min after anesthesia induction(T_(3))were statistically compared.The visual pain simulation score(VAS)was used to evaluate and compare the pain levels of the two groups at 2,4,8,12 and 24 h after surgery.Results:The postoperative extubation time and postoperative recovery time of the control group were longer than those of the pretreatment 1 group and pretreatment 2 group,and the postoperative analgesic drug consumption of the control group was higher than that of the Pretreatment 1 group and pretreatment 2 group(P<0.05).There was no significant difference in the postoperative extubation time,postoperative recovery time,and postoperative analgesic dosage between the pretreatment 1 group and the pretreatment 2 group(P>0.05).The T_(2) and T_(3) HR and MAP of the control group were higher than that of the pretreatment 1 group and the pretreatment 2 group(P<0.05).But there was no statistically si

关 键 词：布托啡诺 预处理 全身麻醉 肩关节镜手术 臂丛神经阻滞 

分 类 号：R971.2[医药卫生—药品]