Clinical Application Of Different Doses Of Butorphanol For Preemptive Analgesia In Minimally Invasive Gynecologic Surgery

Objective:This study investigated the effect of different doses of butorphanol on perioperative analgesia and intraoperative circulation in minimally invasive gynecological surgery,to explore the optimal dose of butorphanol preemptive analgesia.Methods:80 patients who underwent elective minimally invasive gynecological surgery?laparoscopic total hysterectomy,laparoscopic myomectomy and laparoscopic adnexectomy,operating time 1-2h?were randomly divided into four groups:the control group?group C?and the experimental groups that were given butorphanol 5ug/kg?group B1?,10ug/kg?group B2?and 15ug/kg?group B3?,with 20 patients in each group.At 5minutes before the induction of anesthesia,patients in the experimental group were given different doses of butorphanol,and patients in the control group were given normal saline;HR and MAP of the patients were recorded at the time of admission?T0?,before intubation?T1?,after intubation?T2?,establishment of pneumoperitoneum?T3?,and extubation?T4?;The ocurrence of cough and myoclonus of the induced patients was observed.Total amount of intraoperative remifentanil pumped was recorded.The agitation,duration of tube extraction and visual analog scale?VAS?and Ramsay scores after tube extraction were evaluated.Results:The incidence of cough and myoclonus in group B2 and B3 was significantly lower than that in group C,and the hemodynamics at T2,T3 and T4 were more stable than that in group C.The amount of remifentanil used during operation in group B2 and B3 was lower than that in group C.In terms of the score of agitation during the recovery period and the score of analgesia and sedation after extubation,there was a significant difference between group B3 and group C,and there was a significant difference between group B2 and group C in the score of analgesia.There was no difference between 4 groups in adverse reaction and SpO₂ of during PACU.Conclusion:Preoperative administration of 10ug/kg or 15ug/kg butorphanol can effectively inhibit the occurrence of cough and myoclonus during induction,betterinhibit the cardiovascular response during intubation,and provide good preemptive analgesic effect at the beginning of the operation and during the establishing pneumoperitoneum.Butorphanol 15ug/kg can significantly reduce the occurrence of agitation in the recovery period and provide better postoperative analgesic and sedative effects.