The Effects By Preliminary Injection Of Butorphanol On Extubation And Recovery Period Of General Anesthesia In Senile Patients Scheduled For Radical Gastrectomy

Objective To investigate the clinical effects of butorphanol tartrate with different doses and its influence on extubation and recovery period in senile patients scheduled for radical gastrectomy under general anesthesia,and discussing the appropriate dose of intravenously administered butorphanol tartrate for gerontal patients.Methods A total of 120 senile patients who were classified as American Society of Anesthesiologists physical status I-II,scheduled for radical gastrectomy under general anesthesia,were enrolled in this study.They were randomly allocated to four groups according to random number table,divided into group B1,group B2,group B3 and group C,with 30 cases in each group.Once patients came into the operation room the regular monitoring and invasive arterial blood pressure monitoring had been implemented.Each patient was administered with epidural block,and when the sensory levels were finally went to T4-12,could they got the routine anesthesia induction.Groups B1,B2,B3 received respectively Intravenous injection of butorphanol by 0.01 mg·kg-1 0.02 mg·kg-1,0.03mg·kg-1 in 5 minutes before anesthesia induction,and group C received 10 ml normal saline at the same time point.Anesthesia induction were carried out according to this:midazolam 0.05mg·kg-1,fentanyl 0.003 mg·kg-1,the benzene sulfonic acid atracurium 0.15 mg·kg-1,etomidate fat emulsion injection 0.3mg·k-1.During the operation,we gave patients 0.375%ropivacaine through epidural tube regularly,and gave them muscle relaxants 0.05mg once a time according to the results on the TOF-Watch.The maintenance of anesthesia by propofol 40μg·kgmin-1 combined with sevoflurane(1%-2%).Comparison of physical signs(HR.BP)was taken right before intravenous injection of anesthesia induction drug(T1),at the end of operation(T2),during extubation(T3),5 min after extubation(T4),and 10min after extubation(T5).Measured the blood glucose,and cortisol,Angiotensin-II through elasa.Observer’s assessment of alertness/sedation(OAA/S)and adverse reactions were recorded during extubation and in 5 min,10 min,20min(T6)after extubation.Results During the extubation period,Groups B2 and B3 had lower blood glucose,cortisol and angiotensin-II compared with Group C(P<0.05).Group B3 had the lowest OAA/S scores than the other three groups(P<0.05).Groups B3 had much higher incidence of postoperative adverse reactions than other groups.Conclusions Implement of butorphanol by 0.02mg/kg can stabilize recovery in senile patients who undergo selective traditional radical gastrectomy,reduce stress reaction in extubation period,along with moderate postoperative sedation and no remarkable adverse reactions such as nausea and vomiting.