Effects Of Butorphanol Tartrate On The Quality Of Recovery After Microvascular Decompression In Hemifacial Spasm Patients

Objective:Microvascular decompression is an important means to relieve hemifacial spasm.Butorphanol tartrate is a mixed opioid analgesic drug.Compared with traditional opioids,the drug has a good analgesic effect and a low incidence of adverse drug reactions,so it is widely used in perioperative analgesia and clinical anesthesia.Therefore,this study will investigate the effects of different doses of butorphanol tartrate on the quality of recovery in patients undergoing microvascular decompression of facial spasm.Methods:The study selected a total of 120 cases of ASA Grade?and?aged 25 to 70 who underwent hemifacial nerve microvascular decompression from November 2018 to November 2019 in liaoning provincial people's hospital.SPSS 23 software was used to randomize all participants into 4 groups,with 30 patients in each group.The four groups were the normal saline group?group A,n=30?,the low-dose butorphanol group?group B,n=30?,the medium-dose butorphanol group?group C,n=30?,the high-dose butorphanol group?group D,n=30?.All the patients use the same way of intravenous-inhaled general anesthesia,etomidate,sufentanil,cis-atracurium were used for induction of intravenous anesthesia,dexamethasone and tropisetron were used for auxiliary anesthesia.After the insertion of the laryngeal mask was completed,sevoflurane was continuously inhaled and a combination of propofol and remifentanil was administered intravenously at the beginning of the operation.When the microscope was removed,normal saline with the same volume of intravenous injection was given to group A,butorphanol was given to group B at 5?g/kg,group C at 10?g/kg,group D at 20?g/kg,respectively.BIS was maintained between 40 and60 during the operation to ensure sufficient anesthesia depth and avoid intraoperative awareness of patients under general anesthesia.During the operation,the patient's vital signs were ensured to be stable,and the fluctuation range of circulatory system parameters was less than±20%of the basic value.Data collection time points in this study were T₀?5min after entering the operating room?,T₁?immediately after turning in lateral position?,T₂?immediately after extubation?and T₃?10min after extubation?.The experiment mainly monitoring indexes in the study including T₃moment of pain score?NRS?,the other four data collection to collect blood oxygen saturation?Sp O2?,bispectral index?BIS?,systolic blood pressure?SBP?,diastolic blood pressure?DBP?,mean arterial pressure?MAP?,heart rate?HR?.T₂moment of agitation score?RSS?,and Ramsay sedation scores were recorded.The incidence of postoperative nausea and vomiting and respiratory depression was recorded.Results:A total of 120 cases were completed,including 30 cases in group A,30 cases in group B,30 cases in group C and 30 cases in group D.There is no significant difference in general information of age,gender,height,weight,BMI and surgical site in the four groups?P>0.05?.There was no significant difference in the surgery time,anesthesia time,microscope-operation time,withdrawal-extubation time,and propofol dosage among the four groups?P>0.05?.The BIS values of the 4 groups patients were not statistically different at 4 time points?P>0.05?.There was no significant difference in the MAP and HR of the four groups at time T₀and T₁?P>0.05?.There was a statistically significant difference between group D and the control group at time T₂?P<0.05?,and a statistically significant difference in MAP and HR between group D and control group at time T₃?P<0.05?.There was significant difference in HR between group C and control group.Group D agitation score?RSS?was statistically different than the control group?P<0.05?,group C and group D were significantly different than the control group pain score?NRS??P<0.05?.There were no statistical difference between the experimental group and control group patients in Ramsay sedation scores?P>0.05?.Postoperative complications of nausea and vomiting were not statistically different in the 4 groups?P>0.05?.Conclusion:Intravenous injection of 20?g/kg butorphanol before operation end could relieve hemifacial spasm patients postoperative pain,reduce the incidence of restlessness and maintain a stable hemodynamic state during recovery,and there were no obvious adverse reactions after operation.Application of 10?g/kg butorphanol could reduce the severity of pain during recovery,but had no significant effect on the occurrence of restlessness.Administration of 5?g/kg butorphanol before operation end had no significant effect on pain and restlessness during recovery.