Comparison Of Butorphanol Tartrate Nasal Spray And Injection On Emergency Agitation In Patients Undergoing Arthroscopic Cruciate Ligament Reconstruction(ACLR)

Objective:To compare the effects of butorphanol tartrate nasal spray and injection on EA in patients undergoing arthroscopic cruciate ligament reconstruction（ACLR）.Methods:One hundred and thirty-five patients scheduled for ACLRwere enrolled and randomly assigned into three groups,The BN group（n=45）received butorphanol tartrate nasal spray 1mg and the BI group（n=45）received butorphanol injection 1mg at 15 min before induction of anesthe-sia,1m L saline were gived to patients at the same time in group C（n=45）.All groups were received general anesthesia combined with SIFIB,PCI A was given after operation.The Ramsay scores and Sp O₂were recorded when medication（T₀）,at 5min（T₁）,10min（T₂）,15min（T₃）after medication and arriving at PACU（T₄）.Record the sufentanil and remifentanil dosage,operation and tourniquet duration of time,awakening time,extubation time of tracheal tube and PACU stay time.The number of cases who agitated were record respectively at the operation room（D₁）and PACU（D₂）.The incidence and severity of EA and the usage of propofol were recorded in the recovery period.The VAS scores were evaluated when arriving at PA CU（T₄）and 6h（T₅）,12h（T₆）,24h（T₇）after the operation.The requireme-nts for flurbiprofen axetil were recorded too.The Qo R-15 questionnairewere did at T₇.The incidence of side effects such as shivering,drowsiness,PONV and self-extubation were recorded.Results:There were no statistically significant difference in the generaldata among the patients in the three groups（P>0.05）.The ramsay scores were higher and Sp O₂relatively lower in BI group than those in BN and BI at T₁,T₂and T₃（P<0.05）.There were statistically significant difference in ramsay scores between BN and C group at T_2,T₃（P<0.05）,but they had no statistically significant difference in Sp O₂ at the same time.There were no significant differences in sufentanil and remifentanil dosage,operation time,tourniquet time,awakening time,extubation time of tracheal tube and PACU stay time（P>0.05）.The incidence and severity of EA in group C were significantly higher than those in group BN and BI when awake（P<0.05）,but there were no statistically significant difference in the usage of propofol（P>0.05）.The VAS scores were significantly higher in group C at T₄and T₅（P<0.05）,there were no statistical differences at T₆and T₇in the three groups（P>0.05）.The usage of flurbiprofen axetil was lower in group BN and BI（P<0.05）.The postoperative Qo R-15 scores were higher in group BN and BI than those in group C at T₉（P<0.05）.Compared to group C,the incidence of shivering was lower in group BN and BI（P<0.05）.There were no statistically differences in the incidence of postoperative side-effects such as drowsiness,PONV and self-extubation in the three groups（P>0.05）.Conclusion:Butorphanol tartrate nasal spray and injection can reduce the incidence and severity of EA,release postoperative acute pain and shivering,improve postoperative recovery quality in patients undergoing ACLR without increasing emergency time and adverse reactions.However,butorphanol injection may cause Sp O₂ descending in the early stage after administration,and the spray is relatively safe,worthy of clinical application.