Mishra Ld, Rajkumar N, Singh Sn, Dubey Rk, Yadav G
Professor and Head, Division of Neuroanaesthesia.
Indian J Anaesth. 2009 Jun;53(3):324-9.
Propofol and isoflurane have well proven roles as intravenous and inhalational anaesthetics respectively in neurosurgery. We conducted this study to know the outcome using butorphanol as an intraoperative analgesic. Sixty craniotomy patients randomly divided into two groups of 30 each were included in this study. Group A patients were induced and maintained with propofol. Group B patients were induced with thiopentone and maintained with isoflurane. All patients were administered 30mug.kg(-1) butorphanol intravenously 10 minutes before induction of anaesthesia, followed by slow injection of 30mug.kg(-1) midazolam. All were assessed for sedation, respiratory insufficiency, postoperative nausea and vomiting (PONV) and other side effects in the recovery room. We found no difference in demographic parameters between the groups. The fall in HR was maintained in the post induction / intubation period and throughout the intraoperative period in Group A, unlike Group B patients in whom it rose significantly following intubation. Butorphanol was found to be a safe intraoperative analgesic in neurosurgical patients. In addition, it was associated with statistically better haemodynamics and earlier recovery when used with propofol as compared to thiopentone-isoflurane anaesthesia.
丙泊酚和异氟烷分别作为静脉麻醉药和吸入麻醉药在神经外科手术中已被充分证明具有重要作用。我们进行这项研究以了解使用布托啡诺作为术中镇痛药的效果。本研究纳入了60例开颅手术患者,随机分为两组,每组30例。A组患者采用丙泊酚诱导和维持麻醉。B组患者采用硫喷妥钠诱导,异氟烷维持麻醉。所有患者在麻醉诱导前10分钟静脉注射30μg·kg⁻¹布托啡诺,随后缓慢注射30μg·kg⁻¹咪达唑仑。在恢复室对所有患者进行镇静、呼吸功能不全、术后恶心呕吐(PONV)及其他副作用的评估。我们发现两组患者的人口统计学参数无差异。与B组患者不同,A组患者在诱导后/插管期及整个术期心率均维持下降状态,而B组患者在插管后心率显著上升。布托啡诺被发现是神经外科手术患者安全的术中镇痛药。此外,与硫喷妥钠-异氟烷麻醉相比,布托啡诺与丙泊酚联合使用时,具有统计学上更好的血流动力学表现和更早的恢复。