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| Effect of butorphanol used after transumbilical single-port laparoscopic myomectomy and its influence on oxygenation index and stress response |
| The Third People's Hospital of Xindu District, Chengdu, Sichuan Province, 610504 |
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Abstract To explore the analgesic effect of butorphanol used after transumbilical single-port laparoscopic myomectomy of patients, and to study its influence on oxygenation index and stress response of the patients. Methods: 142 patients who wanted transumbilical single-port laparoscopic myomectomy were selected and were divided into the observation group(71 cases with 207 myomas)and control group(71 cases with 221 myomas)according to the random number table method between October 2020 and October 2021. The patients in the observation group were given butorphanol combined with sufentanil for postoperative analgesia, and the patients in the control group were given sufentanil for postoperative analgesia. The score by Numeric Rating Scale(NRS), the oxygenation index, such as PaO2/FiO2 value, the values of respiratory rate(RR), heart rate(HR), and mean arterial pressure(MAP)of the patients at 2h, 4h, 12h, and 48 h after operation, the dosage of analgesics and the number of effective compressions of analgesic pump within 48h after operation, and the levels of the angiotensin Ⅱ(AngⅡ), cortisol(Cor), and β-endorphin(β-EP)at 12h, and 48h after operation of the patients were compared between the two groups. The incidence of adverse reactions related to the use of analgesic pump after operation of the patients in the two groups was recorded. Results: The NRS score, and the values of RR, HR and MAP of the patients in the observation group at 2h, 4h and 12h after operation were significantly lower than those of the patients in the control group, and the PaO2/FiO2 value of the patients in the observation group at 2h, 4h, and 12h after operation was significantly higher than that of the patients in the control group. Within 48h after operation, the dosage of analgesic agent(73.9±10.5ml)and the effective pressure times of analgesic pump(8.4±2.2 times)of the patients in the observation group were significantly lower than those(85.2±12.4ml and 10.3±3.9 times)of the patients in the control group(all P＜0.05). There were no significant differences in the NRS score, the values of PaO2/FiO2, RR, HR, and MAP of the patients at 48h after operation between the two groups(P＞0.05). The levels of AngⅡ(304.51±16.49 ng/L), Cor(302.32±35.69μg/L), and β-EP(37.22±9.77μg/L)of the patients in the observation group at 24h after operation were significantly lower than those(322.25±18.98ng/L, 345.75±48.28μg/L, and 46.26±10.14μg/L)of the patients in the control group(all P＜0.05). There was no significant difference in the indexes of the patients at 48h after operation between the two groups(P＞0.05). The total incidence of adverse reactions related to analgesic pump used(5.6%)of the patients in the observation group was significantly lower than that(16.9%)of the patients in the control group(P＜0.05). Conclusion: Butorphanol used after transumbilical single-port laparoscopic myomectomy of the patients can improve their postoperative analgesic effect, effectively reduce the dosage of postoperative analgesic drugs, and its related side effects, and which has positive effect on reducing postoperative stress response, with higher safety.
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