RESUMEN
Objective:To observe the effect of preoperative application of butorphanol tartrate on postoperative recovery quality in patients undergoing thoracoscopic lobectomy.Methods:A prospective selection was conducted on 96 lung cancer patients who underwent thoracoscopic lobectomy and were admitted to Linyi People′s Hospital from May 2021 to September 2021. They were randomly divided into observation group and control group using a random table number method, with 48 patients in each group. The observation group received intravenous injection of 0.02 mg/kg butorphanol tartrate 15 minutes before anesthesia induction; The control group was given an equal volume of physiological saline. The operation site, operation time, remifentanil dosage during operation, heart rate (HR) and mean arterial pressure (MAP) at each time point of admission (T 0), intubation (T 1), 5 min after intubation (T 2), extubation (T 3), 5 min after extubation (T 4), and 15 min into post-anaesthesia care unit (PACU) (T 5) were recorded; The awakening Restlessness score (RS), Ramsay score, Visual Analogue Scale (VAS) score at T 4 and T 5, the time required from completion to extubation, and postoperative anesthesia related adverse reactions were evaluated. Results:There was no significant difference in the operation site, operation time and remifentanil dosage between the two groups (all P>0.05). Compared with T 0, the HR at T 2, T 3 and T 4, MAP at T 1, T 2, T 3 and T 4 in the two groups decreased significantly (all P<0.05). The HR of the observation group at T 1 and T 3 was significantly lower than that of the control group, and the difference was statistically significant (all P<0.05). The VAS scores of T 4 and T 5 in the observation group were lower than those in the control group after surgery, while the Ramsay score were higher than those in the control group (all P<0.001). The incidence of postoperative restlessness, nausea and vomiting in the observation group was lower than that in the control group ( P<0.05). Conclusions:Administering 0.02 mg/kg butorphanol tartrate 15 minutes before anesthesia induction can improve the quality of recovery in patients undergoing thoracoscopic lobectomy, reduce restlessness and related adverse reactions during recovery.
RESUMEN
Objective To study the effect of dexmedetomidine hydrochloride injection ( Dex) on awakening quality in Pediatric Patients with congenital heart disease undergoing fast_track anesthesia and whole Video_assisted thoracoscoPic surgery. Methods One hundred and twenty Pediatric Patients ( ASA I orIIleVel) with congenital heart diseases were randomly chosen for this study. They receiVed femoral artery and Vein cannulation to establish cardioPulmonary byPass and three small holes were obtained in the right chest for the PurPose of undergoing the whole Video_assisted thoracoscoPic surgery on rePairmen of atrial sePtal defect or simPle Ventricular sePtal defect. They were randomly diVided into two grouPs: Dex_assisted fast_track anesthesia grouP (D grouP,n=60) and general fast_track anesthesia grouP (C grouP,n=60). Each one in grouP D was injected with loading dose of Dex (1 μg·kg-1),then was intraoPeratiVely infused with maintenance dose of 0. 5 μg·kg-1·h-1. Children in grouP C were giVen the same dose of saline in the same way. Hemodynamic changes in the two grouPs at each time Point:before anesthesia ( t0 ) ,at the time of extubation ( t1 ) ,5 min Post_extubation ( t2 ) ,10 min Post_extubation ( t3 ) ,15 min Post_extubation ( t4 ) , 30 min Post_extubation (t5) and at the time of transferring out of CICU (t6),resPectiVely,were obserVed. Restlessness extent, incidence,time of eye oPening after calling, fully awaking time, extubation time, the time of transferring out of CICU and VAS scores,were also recorded. Results From t0 to t2-t5 ,SBP in D grouP was decreased from (114. 2±10. 5) mmHg to (107. 2±10. 3) -(105. 3±11. 3) mmHg,DBP decreased from (61. 3±9. 2) mmHg to (58. 8±7. 8) -(57. 3±6. 3) mmHg,and HR gradually decreased from (95. 2±15. 7) time·min-1 to (85. 7±13. 7)-(83. 3±12. 6) time·min-1,with significant differences (P0. 05). VAS at 30 min after extubation was significantly higher in grouP C than in grouP D(4. 7±0. 7 vs. 2. 4±0. 6,P<0. 05). Conclusion Injection of Dex with loading dose (1 μg·kg-1) and intraoPeratiVe infusion of maintenance dose of 0. 5 μg·kg-1·h-1 in children with congenital heart disease undergoing fast_track anesthesia and whole Video_assisted thoracoscoPic surgery could be conduciVe to maintain hemodynamic stability, reduce restlessness occurrence, enhance security during awakening Process, and alleViate Post_oPeratiVe Pain.