术前应用酒石酸布托啡诺对胸腔镜下肺叶切除术患者苏醒质量的影响  

The effect of preoperative application of butorphanol tartrate on the quality of recovery in patients undergoing thoracoscopic lobectomy

作　　者：麻晓晨 王桂娟 吴海燕[2] 管伟 李希明[2] Ma Xiaochen;Wang Guijuan;Wu Haiyan;Guan Wei;Li Ximing(Graduate Training Base of Linyi People′s Hospital,Jinzhou Medical University,Linyi 276000,China;Department of Anesthesiology,Linyi People′s Hospital,Linyi 276000,China;College of Anesthesia,Weifang Medical University,Weifang 261053,China)

机构地区：[1]锦州医科大学临沂市人民医院研究生培养基地,临沂276000 [2]临沂市人民医院麻醉科,临沂276000 [3]潍坊医学院麻醉学院,潍坊261053

出　　处：《中国医师杂志》2023年第5期695-699,共5页Journal of Chinese Physician

基　　金：江苏省麻醉学重点实验室开放研究课题资助项目(XZSYSKF2020041)。

摘　　要：目的观察术前应用酒石酸布托啡诺对胸腔镜下肺叶切除术患者术后苏醒质量的影响。方法前瞻性选取临沂市人民医院2021年5月至9月收治的96例择期行胸腔镜下肺叶切除术的肺癌患者,采用随机数字表法分为观察组和对照组,每组48例。观察组在麻醉诱导前15 min静脉注射0.02 mg/kg酒石酸布托啡诺;对照组给予等容量的生理盐水。记录两组患者手术部位、手术时间、术中瑞芬太尼用量,入室时(T0)、插管时(T_(1))、插管后5 min(T_(2))、拔管时(T_(3))、拔管后5 min(T_(4))及进入PACU 15 min(T_(5))各时间点的HR和MAP;评价苏醒躁动程度评分(RS)、Ramsay评分,T_(4)和T_(5)时的VAS评分,记录术毕至拔管所需要的时间及术后麻醉相关不良反应。结果两组患者手术部位、手术时间、瑞芬太尼用量差异均无统计学意义(均P>0.05)。与T0时相比,两组T_(2)、T_(3)和T_(4)时的HR降低,T_(1)、T_(2)、T_(3)和T_(4)时的MAP降低,差异有统计学意义(均P<0.05)。观察组T_(1)和T_(3)时的HR明显低于对照组,差异有统计学意义(均P<0.05)。观察组T_(4)和T_(5)时的VAS疼痛评分,术后RS评分低于对照组,Ramsay评分高于对照组(均P<0.001)。观察组术后躁动、恶心呕吐发生率均低于对照组(P<0.05)。结论麻醉诱导前15 min给予0.02 mg/kg酒石酸布托啡诺,可提高胸腔镜下肺叶切除术患者的苏醒质量,减少苏醒期躁动及相关不良反应。Objective To observe the effect of preoperative application of butorphanol tartrate on postoperative recovery quality in patients undergoing thoracoscopic lobectomy.Methods A prospective selection was conducted on 96 lung cancer patients who underwent thoracoscopic lobectomy and were admitted to Linyi People′s Hospital from May 2021 to September 2021.They were randomly divided into observation group and control group using a random table number method,with 48 patients in each group.The observation group received intravenous injection of 0.02 mg/kg butorphanol tartrate 15 minutes before anesthesia induction;The control group was given an equal volume of physiological saline.The operation site,operation time,remifentanil dosage during operation,heart rate(HR)and mean arterial pressure(MAP)at each time point of admission(T0),intubation(T_(1)),5 min after intubation(T_(2)),extubation(T_(3)),5 min after extubation(T_(4)),and 15 min into post-anaesthesia care unit(PACU)(T_(5))were recorded;The awakening Restlessness score(RS),Ramsay score,Visual Analogue Scale(VAS)score at T_(4) and T_(5),the time required from completion to extubation,and postoperative anesthesia related adverse reactions were evaluated.Results There was no significant difference in the operation site,operation time and remifentanil dosage between the two groups(all P>0.05).Compared with T0,the HR at T_(2),T_(3) and T_(4),MAP at T_(1),T_(2),T_(3) and T_(4) in the two groups decreased significantly(all P<0.05).The HR of the observation group at T_(1) and T_(3) was significantly lower than that of the control group,and the difference was statistically significant(all P<0.05).The VAS scores of T_(4) and T_(5) in the observation group were lower than those in the control group after surgery,while the Ramsay score were higher than those in the control group(all P<0.001).The incidence of postoperative restlessness,nausea and vomiting in the observation group was lower than that in the control group(P<0.05).Conclusions Administering 0.02 mg/kg butorphanol

关 键 词：胸腔镜检查 肺切除术 布托啡诺 预防性镇痛 苏醒质量 

分 类 号：R655.3[医药卫生—外科学]