Clinical Observation Of Butorphanol For Postoperative Acute Pain In Patients Undergoing Breast Cancer Surgery

Objective:To observe the clinical efficacy of three different doses of butorphanol for the treatment of postoperative acute pain in patients undergoing breast cancer surgery.Expect to study and explore the optimal dosage.Methods:A total of sixty patients of ASA?American Society Anesthesiologist?physical status?or?,aged 18-65,weighing 45-80kg,BMI?body mass index?<30 who undergoing elective modified radical mastectomy+sentinel lymph node biopsy under general anesthesia was enrolled in this study.According to the different dosage of butorphanol,the patients were randomly divided into three groups:butorphanol 10ug/kg?group A,n=20?,butorphanol 20ug/kg?group B,n=20?and butorphanol 30 ug/kg group?group C,n=20?.All patients were signed informed consent,accepted intravenous anesthesia and insert laryngeal mask.The anesthesia is completed by the same anesthesiologist,and the operation is performed by the same group of surgeons.Remove the laryngeal mask after the end of anesthesia.Patients with Ramsay sedation score<4 and NRS?numerical rating scale?>4 points were randomly assigned to intravenous injection of 10 ug/kg 20 ug/kg or 30 ug/kg of butorphanol.Observe and record the NRS pain score,BCS score,Ramsay sedation score,vital signs:SBP,DBP,HR,SpO₂,RR,at the time of patients were given intravenous injection of butorphanol?T₀?,5 minutes after injection of the drug?T₁?,10 minutes after the injection of the drug?T₂?,15 minutes after the injection of the drug?T₃?,30 minutes after the injection of the drug?T₄?,60 minutes after the injection of the drug?T₅?.Record the occurrence of adverse reactions such as respiratory depression,nausea and vomiting,dizziness,lethargy.All patients were scored by the same anesthesiologist who was unaware of the patient's medication.Results:1.There were no significant differences between the three groups with age,body mass index,ASA grade,operation time.?P>0.05?.2.Compared with T₀,there was no significant difference in SBP,DBP,HR,SpO₂ and RR at T₁^T₅ in each group?P>0.05?.3.?1?The NRS scores in group A,B and C were all significant lower at T₁-T₅than T₀,and in group B and C were significant lower than that in group A?P<0.05?.The score of NRS decreased most significantly at T₂.And the NRS score in group C was lower than that in group B at T₂?P<0.05?.?2?Ramsay scores in group B and C were all significant higher at T₁-T₅ than T₀?P<0.05?.The Ramsay scores of group B and C at T₁-T₅ were higher than those in group A?P<0.05?There was no significant difference between group B and C?P>0.05?.?3?Compared with T₀,BCS scores at T₁-T₅ were significantly increased in group B and C?P<0.05?,group B and C were significantly higher than group A?P<0.05?,group B was higher than group C,but the difference has not statistically significant?P>0.05?.4.In group C,3 patients developed lethargy,which occurred in 25min,30min and 45min after injection,respectively.One patient developed headache which occurred 30min after injection.One patient in group B developed lethargy which occurred 40min after injection.Lethargy,headache occurred in group C significantly higher than group A,B.All three groups has no nausea,vomiting,respiratory depression occurred.CONCLUSION:Butorphanol single injection is safe and effective for the treatment of acute pain after modified radical mastectomy.20 ug/kg has good analgesic effect and the adverse reactions such as drowsiness and headache occur less,which is the best dose.