酒石酸布托啡诺对减轻罗库溴铵注射痛及麻醉诱导期血流动力学的影响

目的观察酒石酸布托啡诺预处理对减轻罗库溴铵注射痛及麻醉诱导期血流动力学的影响。方法选择2019-01~2019-06在该院行气管插管全身麻醉的择期手术患者90例,采用随机数字表法将其随机分为B1组(予布托啡诺20μg/kg)、B2组(予布托啡诺30μg/kg)和C组(予等量的生理盐水),每组30例。比较三组在给予布托啡诺前(T0)、注射布托啡诺后即刻(T1)、注射罗库溴铵前即刻(T2)、给予罗库溴铵即刻(T3)、注射罗库溴铵2 min后(T4)患者的平均动脉压(MAP)、心率(HR)和血氧饱和度(SpO2)水平。并应用Ambesh评分法对三组的注射痛评分情况及不良反应发生情况进行比较。结果三组MAP整体呈先上升后下降的趋势,B1组的幅度高于B2组而低于C组,三组间变化趋势差异有统计学意义(P<0.05);B1、B2组HR呈下降后轻度升高继而又下降的趋势,C组HR在T 3时点升高幅度大,B1、B2组HR较C组波动小,三组间变化趋势差异有统计学意义(P<0.05);三组SpO2整体均呈逐渐升高趋势,C组在T3时点出现降低,三组间变化趋势差异有统计学意义(P<0.05)。三组间注射痛发生率比较差异有统计学意义(P<0.05);B1、B2组注射痛发生率显著低于C组(P<0.05),而B2组注射痛发生率显著低于B1组(P<0.05)。三组间不良反应发生率比较差异无统计学意义(P>0.05)。结论酒石酸布托啡诺预处理能够安全有效地降低罗库溴铵注射痛的发生率,减少麻醉诱导期血流动力学波动,且30μg/kg处理效果优于20μg/kg。

Effects of butorphanol tartrate on relieving rocuronium injection pain and haemodynamics during induction of anesthesia

Objective To observe the effects of butorphanol tartrate pretreatment on relieving rocuronium injection pain and haemodynamics during induction of anesthesia.Methods A total of 90 selected patients who underwent endotracheal intubation under general anesthesia in our hospital from January 2019 to June 2019 were randomly divided into group B1(butorphanol 20μg/kg),group B2(butorphanol 30μg/kg)and group C(normal saline of the same quantity)by random number table method,with 30 cases in each group.The levels of mean arterial pressure(MAP),heart rate(HR)and percutaneous oxygen saturation(SpO2)were compared among the three groups before giving butorphanol(T0),immediately after injection of butorphanol(T1),immediately before injection of rocuronium(T2),immediately after injection of rocuronium(T3)and 2 min after injection of rocuronium(T4).The scores of injection pain and the incidence of adverse reactions were compared among the three groups using Ambesh score.Results The MAPs of the three groups showed a trend of rising first and then declining.The amplitude of MAP in the group B1 was higher than that in the group B2 and lower than that in the group C,and the difference in the trend of change among the three groups was statistically significant(P<0.05).Group B1 and group B2 showed a slight increase after a slight decrease in HR,while group C showed a large increase at the time point of T3.HR fluctuated less in the group B1 and B2 than in the group C,and the difference in the trend of change among the three groups was statistically significant(P<0.05).SpO2 increased gradually in the three groups,and the group C showed a decrease at the time point of T3,and the difference in the trend of change among the three groups was statistically significant(P<0.05).There was a significant difference in the incidence of injection pain among the three groups(P<0.05).The incidence of injection pain in group B1 and group B2 was significantly lower than that in group C(P<0.05).The incidence of injection pain in group B2 was significantly lower than that in group B1(P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion Butorphanol tartrate pretreatment is safe and effective in reducing the incidence of rocuronium injection pain and reducing hemodynamic fluctuation during induction of anesthesia,and the effect of 30μg/kg is better than that of 20μg/kg.