The Effect Observation Of Butorphanol Combined With Dexmedetomidine For Patient-controlled Intravenous Analgesia After Gastrointestinal Open Surgery

Objective:To observe security and effectiveness of butorphanol combined with dexmedetomidine in patient-controlled intravenous analgesia(PCIA)after gastrointestinal open surgery.Methods:A total of 300 patients scheduled for selective gastrointestinal open surgery,American Society of Anesthesiologists(ASA)ⅠorⅡ,42 males and14 females,age 40~65years,weight 50~80kg,and we had sighed informed consent with family menbers of patients before the operation,were divided into two groups by random digits table:butorphanol combined with dexmedetomidine(B group)and sufentanil combined dexmedetomidine(S group),each group with 30 cases.Analgesics were B group butorphanol 1.5mg/kg+dexmedetomidine 0.1ug /kg/h,S group sufentanil 1.5ug/kg+ dexmedetomidine 0.1ug / kg/h.Both 2 groups were treated with ramosetron 0.6 mg.The same pattern of PCIA was set in the two groups,adding physiological saline to total 100 ml,background infusion 2ml/h,patient controlled analgesia(PCA)0.5ml,locked time15 min.If we donot used dexmedetomidine during the surgery,patients will received 0.5ug/kg dexmedetomidine by intravenous pumping(10min)before the end of the surgery 30 min.If patients received dexmedetomidine during the surgery,no load dose was required.At 1h(T1),2h(T2),6h(T3),12h(T4)and 24h(T5)after PCIA,the patients were followed up with visual analogscale(VAS)and Ramsay scores and BCS scores,the total number of button pressing of PCIA and the number of effective button pressing,additional analgesics cases,adverse effects during postoperative analgesia and satisfaction scores were recorded.Using SPSS 16.0statistical software to process.Results:(1)The age,gender,weight,operation time,anesthesia timein the two groups were not statistically significant(P > 0.05).(2)There was no statistical significance(P > 0.05)for Ramsay sedation scores and VAS scores in both groups.The BCS scores of group B in the time T2 was higher than that of group S,and the difference was statistically significant(P < 0.05).(3)Both groups received excellent analgesia effect,neither group needed any additional pain relievers.The number of compressions were not statistically significant in both groups(P > 0.05).(4)The incidence of nausea and vomiting in group B was significantlly lower than that in group S,and the difference was statistically significant(P<0.05).(5)There was no statistical significance(P > 0.05)for the overall satisfaction in both groups(P>0.05).Conclusion:Butorphanol 1.5mg/kg+dexmedetomidine 0.1ug /kg/h was able to provide satisfactory analgesia effect for the patients after open abdominalsurgery.The analgesia effect was approximately equal to the sufentanil.Butorphanol combined with dexmedetomidine can has lower Incidence of nausea and vomiting and doesnot enhence the Ramsay sedation scores.