Yang Lin, Sun De-feng, Wu Yue, Han Jun, Liu Ruo-chuan, Wang Li-jie
Neuroelectrophysiology Lab, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, P.R.China.
Department of Anesthesiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China.
BMC Anesthesiol. 2015 Feb 2;15:20. doi: 10.1186/1471-2253-15-20.
To evaluate intranasal administration of butorphanol on postoperative pain and early postoperative cognitive dysfunction in old patients undergoing H-uvulopalatopharyngoplasty (H-UPPP).
A total of 260 male patients (65 to 77 years old) with obstructive sleep apnea hypopnea syndrome and scheduled for H-UPPP were divided randomly to receive intranasal butorphanol, intravenous butorphanol, intranasal fentanyl, or intravenous saline (controls). The definition of preemptive analgesia is that the tested drugs are given before anesthesia induction. Visual analog scale (VAS) and Bruggrmann comfort scale (BCS) scores were recorded at postoperative 1, 6, 12, 18, 24, 36, and 48 h. Postoperative cognitive dysfunction (POCD) was evaluated by Mini-Mental State Examination (MMSE) scores assessed one day before, and 1, 3, and 7 days postsurgery.
Compared with control group, those given preemptive analgesia required significantly less sufentanil during surgery, had less pain at postoperative 6-12 h; those given butorphanol experienced less nausea and vomiting, less pain at postoperative 6-24 h, and less POCD. Compared with patients given fentanyl, those given butorphanol required significantly less postoperative fentanyl, had less pain at postoperative 18-24 h, less nausea and vomiting, and less POCD. Compared with patients given intravenous butorphanol, those who received butorphanol by nasal route required significantly less postoperative fentanyl, had less pain at 36 and 48 h, and less POCD.
Intranasal administration of butorphanol is safe and effective, reducing postoperative usage of analgesics and the incidence of POCD in old patients undergoing H-UPPP.
ChiCTR-TRC-14004121.
评估布托啡诺经鼻给药对接受悬雍垂腭咽成形术（H-UPPP）的老年患者术后疼痛及早期术后认知功能障碍的影响。
选取260例年龄在65至77岁、患有阻塞性睡眠呼吸暂停低通气综合征且计划行H-UPPP的男性患者，随机分为经鼻布托啡诺组、静脉布托啡诺组、经鼻芬太尼组或静脉生理盐水组（对照组）。超前镇痛的定义为在麻醉诱导前给予受试药物。分别于术后1、6、12、18、24、36和48小时记录视觉模拟评分（VAS）和布罗格曼舒适度评分（BCS）。术后认知功能障碍（POCD）通过术前1天及术后1、3和7天评估的简易精神状态检查表（MMSE）评分进行评估。
与对照组相比，接受超前镇痛的患者术中所需舒芬太尼显著减少，术后6至12小时疼痛较轻；使用布托啡诺的患者恶心呕吐较少，术后6至24小时疼痛较轻，POCD较少。与使用芬太尼的患者相比，使用布托啡诺的患者术后所需芬太尼显著减少，术后18至24小时疼痛较轻，恶心呕吐较少，POCD较少。与静脉注射布托啡诺的患者相比，经鼻使用布托啡诺的患者术后所需芬太尼显著减少，36和48小时疼痛较轻，POCD较少。
布托啡诺经鼻给药安全有效，可减少接受H-UPPP的老年患者术后镇痛药的使用及POCD的发生率。
ChiCTR-TRC-14004121。
