Clinical And Empirical Observation On Patient-Cont-Rolled Intravenous Analgesic Effec-Ts Of Butorphanol

Objective To observe Clinical observation on patient-controlled intravenous analgesic effects and its impacts on 5-HT, P substance and EPI of butorphanol.Methods 1 Clinical Research Two hundreds and forty ASA(Ⅰ～Ⅱ) patients(20～70 years) underwent general anesthesia were divided into eight groups randomly , thirty patients in each group . Group B1 ,group B2,group B3,group B4,group B5,group B6 received butorphanol one by one 0.004% , 0.005% , 0.006% , 0.007% , 0.008% , 0.009% ; group C1 received morphine 0.0025% ; group C2 received morphine 10mg who needed by intramuscular injection . VAS scores , BCS scores , Ramsay scores , untoward reaction , total frequency and actual frequency of PCA were assessed at 24 hours after analgesias .2 Empirical Research According to the results of clinical research to choose a good analgesic effect, fewer adverse reactions B3 group, select 20 patients who are about to undergo selective operations, aged 20 through 70 years old with their BMIs (Body Mass Index) below 25kg/m2 while their ASA staging between stages I and II. Then randomly divide the 30 patients into: group butorphanol (group B),group morphine(group M) and group control (group D),10 patients each group.Post-operatively patients from group B and group M are given PCIA whereas, for patients from group D, 0.1g of morphine is administrated when they feel the need. Peripheral venous blood samples are collected at 5 different time points of pre-anesthesia induction(T0), 12h(T1), 24h(T2), 36h(T3), and 48h(T4) post-operatively and levels of 5-HT and P substance are measured by enemzy-combined immunosorbernt assay.Results No statistical difference in the analgesic effect was found among butorphanol PCIA group(B3~B6) and morphine PCIA group (p>0.05) ,contrast group PCIA with group C2 , statistical difference in the analgesic effect was found (p<0.05),the untoward reactions of B groups are lower than group C1 .But in group B1 and B2 , about fifty percent patients were in pain ,in order to control pain ,they need other analgesics . Compared to group D, group B and group M has better analgesic effects(p<0.05),the 5-HT , SP and EPI levels of group B produce significant difference (p<0.05).Conclusion Butorphanol 0.006% or 0.007% provides the optimum balance between pain relief and side effects following surgery . Butorphanol PACI could effectively relieve or eliminate post-operative pain and suppress increase of levels of 5-HT and P substance in patients'serum, weakened to some extent, the sensation of pain messages to maintain environmental stability, ease the stress response the body will help patients.