Effect Of Different Doses Of Butorphanol Combined With Ropivacaine On Brachial Plexus Block

Objective:To observe effect of different doses of butorphanol combined with ropivacaine on brachial plexus block.Methods:A total of 120 patients scheduled for upper limb surgery,at The Affiliated Hospital Of North Sichuan Medical College from June 2021 to November 2021 were randomly divided into five groups,saline(group S),butorphanol combined with ropivacaine(corresponding to 10μg/kg:group B10,20μg/kg:group B20,30μg/kg:group B30 and 40μg/kg:group B40 respectively),with 24 cases in each group,the concentration of ropivacaine was 0.33%,the total volume was 30ml.Then supraclavicular brachial plexus block was performed under the guidance of ultrasound and nuerostimulator.Measure indexes:onset time of sensory block and motor block,onset time of complete sensory and motor block and duration of block;pain visual analogue scale scores and BCS scores were measured at 2h(T0),4h(T1),8h(T2),12h(T3),24h(T4)and 48h(T5);Ramsay Sedation scores were measured at 5min before block(t0),15min after block(t1),30min after operation began(t2),1h after operation began(t3),at the end of operation(t4),1h after operation finished(t5),1h after operation finished(t6);Mean arterial pressure(MAP)and heart rate(HR)were measured at 5 min before block(t0),5 min after block(t1),at the beginning of operation(t2),15min after operation began(t3),30min after operation began(t4),1h after operation began(t5),at the end of operation(t6),1h after operation finished(t7)and 2h after operation finished(t8);The anesthetic nerve blocking effect;Qor-15 recovery quality score of patients on the second day after operation were recorded;The times of remedial analgesia and the dosage of remedial analgesics within 48 hours after operation were recorded;The incidence of adverse reactions within 48 hours after operation were recorded.Results:The onset-time and complete onset-time of sensory and motor block in group B20,group B30 and group B40 were significantly shorter than group S(P<0.05);Compared with group S,the duration of block in group B10,B20,B30 and B40 was prolonged significantly(P<0.05);The block onset-time of group B40 was the shortest and the duration of block was the longest;At T1-2，the VAS scores of other groups were significantly lower than group S(P<0.05);At T3,the VAS scores of group B30 and group B40 were significantly lower than group S(P<0.05);At T4,the VAS score of group B40 was significantly lower than group S(P<0.05);At t1,Ramsay sedation score in group B30 and group B40 was significantly higher than group S(P<0.05);At t2-t4,Ramsay sedation score in group B20,group B30 and group B40 was significantly higher than group S(P<0.05);At t5,Ramsay sedation score in group B30 and group B40 was significantly higher than group S(P<0.05);At T2-4,the BCS scores of group B30 and group B40 were significantly higher than S group(P<0.05);At T2,the BCS scores of group B10 was significantly higher than group S(P<0.05);At T2-3,compared with group S,the BCS score of group B20 was significantly higher(P<0.05);The anesthetic nerve blocking effect in group B30 and group B40 were significantly better than group S(P<0.05);The number of remedial analgesia and the dosage of remedial drugs in group B40 decreased significantly within 48 hours after operation than other groups(P<0.05);Qor-15 recovery quality score in group B30 and group B40 was significantly higher than group S(P<0.05);The incidence of dizziness and drowsiness in group B30 and group B40 were higher than group S(P<0.05).Conclusion:The onset time and complete onset time of sensory and motor block were shortened,the duration of block was prolonged dose-dependently when butorphanol combined with ropivacaine was used for supraclavicular brachial plexus block.40μg/kg butorphanol combined with ropivacaine performed the shortest onset time of sensory and motor block and the longest maintenance time,and could provide perfect blocking effect and raise the satisfaction of patients,improve the quality of postoperative recovery,reduce postoperative remedial analgesics use,but it may increase the incidence of dizziness and drowsiness.