NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China.
Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China.
Drug Des Devel Ther. 2023 Mar 20;17:839-849. doi: 10.2147/DDDT.S396309. eCollection 2023.
This study was designed to investigate the effects of different doses of butorphanol on postoperative shivering and quality of recovery in elderly patients.
A total of 147 elderly patients (aged 60 or older) scheduled for elective transurethral resection of the prostate were enrolled in the current study. Patients were randomly and evenly assigned into four groups: Group C (0.9% normal saline), Group B1 (butorphanol 0.01 mg/kg), Group B2 (butorphanol 0.02 mg/kg) and Group B3 (butorphanol 0.03 mg/kg). All drugs were diluted to 5mL and injected intravenously slowly 5 min before induction of anesthesia. The primary outcome measure was the incidence of postoperative shivering in the post-anesthesia care unit. Quality of Recovery-40 (QoR-40) scores were assessed on postoperative day (POD) 1, 2 and 3. Perioperative core and skin temperature, extubation time and adverse events were also recorded.
Patients among the four groups had comparable baseline characteristics. Compared with Group C, the incidence of shivering was significantly lower in Group B2 and B3 ( = 0.006 and = 0.005, respectively). The QoR-40 scores on POD1 were significantly higher in all butorphanol groups than that in Group C ( < 0.0083). In Group B2 and B3, patients experienced lower pain intensity ( < 0.001). In addition, the incidence of catheter-related bladder discomfort (CRBD) was lower in all butorphanol groups than in Group C ( < 0.0083).
Butorphanol 0.02 or 0.03 mg/kg could effectively prevent the occurrence of postoperative shivering in elderly patients scheduled for transurethral resection of the prostate, provided effective postoperative recovery and postoperative analgesia.
本研究旨在探讨不同剂量布托啡诺对老年患者术后寒战和恢复质量的影响。
本研究共纳入 147 例拟行择期经尿道前列腺电切术的老年患者（年龄≥60 岁）。患者被随机平均分为四组：C 组（0.9%生理盐水）、B1 组（布托啡诺 0.01mg/kg）、B2 组（布托啡诺 0.02mg/kg）和 B3 组（布托啡诺 0.03mg/kg）。所有药物均稀释至 5mL，于麻醉诱导前 5min 缓慢静脉注射。主要观察指标为麻醉后恢复室（PACU）内术后寒战的发生率。术后第 1、2 和 3 天采用恢复质量 40 项评分（QoR-40）评估患者的恢复质量。记录围手术期核心体温和皮肤温度、拔管时间及不良反应。
四组患者的基线特征具有可比性。与 C 组相比，B2 组和 B3 组的寒战发生率显著降低（ = 0.006 和 = 0.005）。B2 组和 B3 组患者术后第 1 天的 QoR-40 评分明显高于 C 组（ < 0.0083）。B2 组和 B3 组患者的疼痛强度更低（ < 0.001）。此外，B2 组和 B3 组患者的导尿管相关性膀胱不适（CRBD）发生率低于 C 组（ < 0.0083）。
布托啡诺 0.02 或 0.03mg/kg 可有效预防经尿道前列腺电切术老年患者术后寒战的发生，提供有效的术后恢复和术后镇痛。
