ABSTRACT
Objective To observe the effect of patient controlled intravenous analgesia(PCIA)of remifentanil combined with butorphanol in high-intensity focused ultrasound(HIFU)treatment of uterine fibroids or adenomyosis. Methods A total of 56 patients with uterine fibroids or adenomyosis treated with HIFU were selected.At 15 min before the treatment,1 mg of butorphanol was intravenously injected,and then a PCIA pump was connected.The PCIA solution was butorphanol 2 mg and remifentanil 2 mg diluted to 100 ml.The initial dose was 1 μg/kg,the basal rate was 6 μg· kg-1· h-1,the bolus was 1 μg/kg,and the lock out time was 1 min.The respiratory rate,heart rate,mean arterial pressure(MAP),oxygen saturation(SpO2), VAS scores,and Ramsay sedation scores were recorded at each time points,which were T1(at the beginning of surgery),T2(the vital signs were recorded every 30 min during the surgery,the mean values of the data were taken as T 2 values),T3(the end of surgery),and T4(30 min after the end of surgery).Additional medications and complications,such as dizziness,nausea,vomiting,respiratory depression were recorded,too. Results The operations were accomplished in all the 56 cases.The operation time was(97.8 ±44.7)min.As compared to the T1 time point,the MAP and SpO2during and after treatment at each time points had no significant differences(F=1.398, P=0.245;F=1.819, P =0.155).The respiratory frequency and heart rate during treatment significantly decreased as compared to before treatment(F=109.020,P=0.000;F=115.023,P=0.000).At 30 min after treatment,the respiratory frequency rose but had no significant difference as compared to the baseline(P=1.000).The heart rate also speeded up but still below the level at the beginning of the treatment,with the difference having statistical significance(P=0.002).Analgesia effective rate was 94.6%(53/56).The Ramsey scores were(2.4 ±0.5)points during the treatment,(2.2 ±0.5)points at the end of the treatment,and(2.0 ±0.2)points at 30 min after treatment.The sedation effect was satisfactory. Conclusion PCIA of butorphanol combined with remifentanil is effective and safe for HIFU in the treatment of uterine myoma or adenomyosis.