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| Effect of dexmedetomidine combined with butorphanol for postoperative analgesia after laparoscopic salpingectomy and its influence on the stress reaction |
| Anyang District Hospital, Puyang, Henan Province, 455000 |
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Abstract To investigate the effect of dexmedetomidine combined with butorphanol for analgesia of patients after laparoscopic salpingectomy, and to study its influence on the expression level of serum anti-müllerian hormone(AMH)and tumor necrosis factor-α(TNF-α)of these patients. Methods: 108 patients requiring laparoscopic salpingectomy were selected and randomly divided into group A(54 cases)and group B(54 cases)by random number table method from March 2020 to August 2021. After routine anesthesia induction, the patients in the two groups were given horizontal block of transverse abdominal muscle(injection of 0.25% ropivacaine). Then the patients in group A were intravenously injected with dexmedetomidine, and the patients in group B were intravenously injected with dexmedetomidine and butorphanol. The levels of serum AMH and TNF-α at different times, the analgesic effect within 48 hours by pain visual analogue scale(VAS), the intraoperative propofol and remifentanil dosages, the number of compressions of analgesic pump, and the incidence of adverse reactions of the patients were compared between the two groups. Results: The serum AMH level of the patients in group B immediately after extubation, 24h and 48h after operation were 1.26±0.48μg/L, 1.22±0.47μg/L, and 1.21±0.43μg/L, respectively, which were significantly higher than those(1.06±0.49μg/L, 1.02±0.52μg/L, and 1.02±0.46μg/L, respectively)of the patients in group A. The serum TNF-α level of the patients in group B immediately after extubation, 24h and 48h after operation were 1.33±0.45 ng/ml, 1.13±0.42 ng/ml, and 1.41±0.23 ng/ml, respectively, which were significantly lower than those(2.46±0.57 ng/ml, 1.68±0.51 ng/ml, and 1.26±0.48 ng/ml, respectively)of the patients in group A. The VAS scores at 8h, 12h, and 24h after operation of the patients in group B were significantly lower than those of the patients in group A. The intraoperative doses of propofol(412.37±63.27 mg)and remifentanil(736.54±92.16μg)of the patients in group B were significantly lower than those(783.26±96.78 mg and 446.54±72.56μg)of the patients in group A. The times of analgesic pump pressing of the patients at 4h, 8h, 12h, 24h and 48h after operation were significantly less than those of the patients in group A(all P＜0.05). There was no significant difference in the total incidence of adverse reactions(9.26% vs.7.41%)between the two groups(P＞0.05). Conclusion: Dexmedetomidine combined with butorphanol for the patients after laparoscopic salpingectomy can increase their analgesia effect, and can relieve their stress reaction, reduce the dosages of propofol and remifentanil without increase their adverse reactions.
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