| Objective:To investigate the analgesic intensity of dexmedetomidine versus butorphanol tartrate for moderate postoperative pain stimulation at a certain intravenous infusion dose(0.2?g·kg-1·h-1).Methods:A total of 78 patients,aged 28-60 years,weighing 50-70 kg and ASA grade I-II,were selected for elective thyroidectomy under general anesthesia in Dalian Central Hospital from November to December 2019.The patients were randomly divided into two groups?1:1 distribution?:dexmedetomidine group?group D,n=39?and butorphanol tartrate group?group B,n=39?.Continuous intravenous infusion of dexmedetomidine and single intravenous injection of butorphanol tartrate were used as drug analgesia schemes within 30 min after operation respectively.Group D received a loading dose of dexmedetomidine of 1?g·kg-1?administration time is 10 min?30min before the end of the operation,and continued infusion of 0.2?g·kg-1·h-1until the patient left the resuscitation room.Group B received a single intravenous bolus of butorphanol tartrate of 1 mg 30 min before the end of the operation.Both groups of patients entered the resuscitation room for observation for 30 min,and the pain intensity?VAS score?and sedation score?Ramsay score?were evaluated every 10 min.When the VAS score of the two groups of patients was>3 points,0.5 mg butorphanol tartrate was added every time until the VAS score was below 3 points.The observation index was the dose of butorphanol tartrate added to the two groups.Vital signs of two groups of patients at intervals of 10 min?t4,t5,t6?when entering the operating room?t1?,when pulling out tracheal intubation?t2?,when entering PACU?t3?;VAS score,Ramsay score and adverse events such as extubation choking cough,respiratory depression,agitation,etc.of PACU at various time points;Adverse reactions such as nausea,vomiting,dizziness,skin pruritus and respiratory depression occurred within 24 hours after operation.Results:Compared with group B,,the patients in group D reduced the dose of butorphanol by 36.3%??0.72±0.25?mg vs?1.13±0.22?mg?.under the stimulation of moderate pain intensity,the analgesic intensity was comparable to that of butorphanol of 0.36 mg,and the difference was statistically significant?p<0.01?.The extubation time of patients in group D was longer than that in group B,the difference was statistically significant?p<0.05?.From T2 to T6,the hemodynamic parameters of group D patients at the same time were lower than that of group B,the difference was statistically significant?p<0.05?.At time t6,there was no significant difference in VAS score between the two groups?p>0.05?,while Ramsay score in group D was higher than that in group B,with significant difference?p<0.05?.There were no adverse events such as extubation choking cough,agitation and respiratory depression in group D patients.The incidence of adverse reactions 24 hours after operation in group B was higher than that in group D,the difference was statistically significant?p<0.05?.Conclusion:Dexmedetomidine has a definite analgesic effect,the analgesic intensity under moderate pain stimulation can be equivalent to 0.36 mg butorphanol tartrate,at the same time,it also reduces the use of postoperative opioid analgesic drugs and the occurrence of adverse reactions.Dexmedetomidine can avoid choking cough caused by extubation,reduce blood pressure and heart rate,reduce the occurrence of postoperative hemorrhage,and at the same time,it will not lead to the occurrence of awakening delay and respiratory depression.It has high safety and good comfort,and can become one of the choices of postoperative multimodal analgesics. |
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