| Objective:To study the effect of butorphanol and sufentanil combined with propofol for the anesthesia of transurethral resection of bladder tumor(TURBt)on patients.Methods:60 cases of patients underwent transurethral resection of bladder tumor under intravenous anesthesia with selective time of our hospital was selected,aged 35 to 65 years,and ASA grade : I ~ II grade,the patients were divided into butorphanol(B group)and sufentanil(S group)by random number table method.All patients were fasted for 6hours before operation,no drink for 4 hours,without pre-operative medication.And after entering the operation room,open the upper limb venous access immediately,the routine continuous electrocardiogram(ECG),blood oxygen saturation(Sp O2),noninvasive arterial blood pressure(NBP)and bispectral index(BIS)were recorded,and the oxygen inhalation 3 ~ 4L/min was given.Anesthesia induction: group S was given with 0.075 ?g/kg sufentanil,and 3minutes later the subject was injected slowly with 2 mg / kg propofol;group B was given with 15?g/kg butorphanol,and 3 minutes later the subject was injected slowlywith 2 mg / kg propofol.The consciousness of the patient was observed while intravenous injection was performed.When the patient's consciousness disappeared and the BIS was 55 ± 5,the surgery was performed after that the laryngeal mask was implanted.During the operation,4~7mg·kg-1·h-1propofol pump was used to maintain anesthesia.When the TURBt operation was completed,the infusion of propofol was stopped,waited for the patient to wake up,until that the patient responded correctly to the instruction,the laryngeal mask was pulled out.The patient was sent to the anaesthesia recovery room for observation for a period of time,it was continue to give oxygen inhalation 3 ~ 4L / min and intravenous infusion,the patient with Steward awaken score,which was up to 4 points or more could be sent back to the ward.The patients were observed and recorded changes in NBP,HR,Sp O2 and BIS before anesthesia(T 0),beginning operation(T1),10 min after operation(T2)and waking up(T3),and the waking time was recorded.Followed up and recorded the VAS,Ramsay,and BCS scores after the operation,and observed whether there were respiratory depression and adverse reactions,such as restlessness,nausea,vomiting,dizziness,headache,and so on in the awakening period.Results:There was no significant difference in SBP,DBP and HR between the two groups at T0(P > 0.05);compared with group S,the BIS value ofgroup B at T1 and T2 decreased significantly(P < 0.05).Intra group comparison: the SBP,DBP,HR,BIS values of the two groups decreased significantly in T1?T2,compared with T0(P < 0.05).There was no significant difference in waking time between the two groups(P > 0.05).There was no significant difference in Sp O2 at each time point in group B patients(P > 0.05),and 11 patients in group S,the value at T0 time were compared with at T1 time,there was a significant decrease in Sp O2(P = 0.07),and there was no significant change in T2 and T3.There was no difference in VAS visual score and comfort score(BCS)between the two groups of patients after operation(P > 0.05),and the Ramsay sedation score was higher in group B than in group S(P < 0.05).The incidence of postoperative nausea and vomiting in group B was significantly lower than that of group S(P< 0.05).Conclusion :Transurethral resection of bladder tumor induced by intravenous anesthesia with 15 ?g/kg butorphanol,it could well control the pain during operation,the sedative effect was good,and the hemodynamics was stable during the operation.And the adverse reactions such as postoperative nausea and vomiting and so on were less.It still needed to be further discussed in clinical that the optimal dose of butorphanol in small surgery and the exact equivalent dose of butorphanol and sulfentanil. |
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