| Objectives To compare the analgesic effect and prognosis of butorphanol analgesia regimen and fentanyl analgesia regimen in patients with invasive mechanical ventilation.Methods This was a prospective,randomized,single-blind study.A total of 48 patients in the intensive care unit(ICU)with mechanical ventilation for more than 24 hours were enrolled and randomly assigned to butorphanol or fentanyl.If the condition requires,propofol sedation is given,and titrated gradually to the ideal analgesic and sedative level according to the analgesic sedation score.Disconnection screening and spontaneous breathing tests(SBT)were conducted daily.The end point of the study was successful weaning after offline extubation or tracheotomy,and the longest observation time was 30 days.Results The study included 81 patients on mechanical ventilation in the ICU,49% in the butorphanol group(n=40)and 51% in the fentanyl group(n=41).There was no statistical significance in the acute physiology and chronic health evaluation scoring systemⅡ(APACHE Ⅱ),sequential organ failure assessment(SOFA),glasgow coma scale(GCS),respiratory circulation parameter,liver and kidney function in two groups when they were enrolled(P>0.05).The primary outcome was the proportion of patients in both groups who maintained the target analgesia score at all time points observed 65% of the butorphanol patients(n=26)and 80.5% of the fentanyl patients(n=33)at all time(P=0.182);There was also no significant difference in the number and proportion of patients who remained below the target analgesia score at 90% and 80% of the observation time points(P>0.05);Among secondary outcomes,mechanical ventilation duration(106.5±61.6h vs 145.2±82.1h,P=0.074),length of ICU stay(123.1±74.8h vs 157.3±94.5h,P=0.177),and ICU hospitalization cost [4.2(1.5,7.4)ten thousand yuan vs 4.4(1.4,11.8)ten thousand yuan,P=0.439] showed no statistically significant difference.The dosage of propofol in butorphanol group was significantly lower than that in fentanyl group(1.8±1.5g vs3.7±2.2g,P=0.005).The incidence of adverse drug reactions was very low,and there was no statistical difference between the two groups(P>0.05).There were no statistically significant differences in delirium,tracheotomy,or 30-day mortality between the butorphanol and fentanyl groups(P>0.05).Conclusions In mechanically ventilated patients,butorphanol and fentanyl had similar analgesic effects and both achieved desirable analgesic levels;There is no difference between butorphanol and fentanyl in the comparison of drug-related adverse reactions;Compared with fentanyl,butorphanol reduce the amount of propofol used in patients on mechanical ventilation.Figure 1;Table 8;Reference 192... |
