布托啡诺超前镇痛对胸腔镜下肺癌根治术患者循环系统、呼吸状态及应激状态的影响

Effects of butorphanol preemptive analgesia on circulatory system,respiratory state and stress state in patients undergoing thoracoscopic radical resection of lung cancer

目的探讨布托啡诺超前镇痛对胸腔镜下肺癌根治术患者循环系统、呼吸状态及应激状态的影响。方法选取2020年5月至2021年5月我院收治的200例胸腔镜下肺癌根治术患者为研究对象,以随机数字表法将其分为对照组和观察组,各100例。对照组在术毕前30 min予以患者布托啡诺20μg/kg注射,观察组在麻醉诱导前15 min予以患者布托啡诺20μg/kg注射。比较两组的麻醉相关指标。结果观察组单肺通气后30 min(T_(2))、拔管时(T_(3))时的平均动脉压(MAP)、心率(HR)均低于对照组(P<0.05)。观察组T_(2)、T_(3)时的动脉血氧分压(PaO_(2))高于对照组,动脉血二氧化碳分压(PaCO_(2))低于对照组(P<0.05)。观察组插管时(T_(1))、T_(2)、T_(3)时的皮质醇(Cor)、去甲肾上腺素(NE)水平均低于对照组(P<0.05)。观察组T_(2)、T_(3)时的超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平均低于对照组(P<0.05)。结论对胸腔镜下肺癌根治术患者采用布托啡诺超前镇痛有助于促进其循环系统稳定,改善呼吸状态,减轻应激状态,值得推广。

Objective To explore the effects of butorphanol preemptive analgesia on circulatory system,respiratory state and stress state in patients undergoing thoracoscopic radical resection of lung cancer.Methods A total of 200 patients undergoing thoracoscopic radical resection of lung cancer admitted in our hospital from May 2020 to May 2021 were selected as the research objects and divided into control group and observation group by random number table method,with 100 cases in each group.The control group was injected with butorphanol 20μg/kg at 30 min before the end of operation,and the observation group was injected with butorphanol 20μg/kg at 15 min before anesthesia induction.The anesthesia related indexes of the two groups were compared.Results At 30 min after one-lung ventilation(T_(2))and the time of extubation(T_(3)),the mean arterial pressure(MAP),heart rate(HR)in the observation group were lower than those in the control group(P<0.05).At T_(2) and T_(3),the partial pressure of oxygen(PaO_(2))in the observation group was higher than that in the control group,and arterial carbon dioxide pressure(PaCO_(2))was lower than that in the control group(P<0.05).At intubation(T_(1)),T_(2) and T_(3),the levels of cortisol(Cor),norepinephrine(NE)in the observation group were lower than those in the control group(P<0.05).At T_(2) and T_(3),the levels of hypersensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)in the observation group were lower than those in the control group(P<0.05).Conclusion The butorphanol preemptive analgesia applied in patients undergoing thoracoscopic radical resection of lung cancer is helpful to promote the stability of their circulatory system,improve respiratory status,and reduce stress status,which is worthy of promotion.