布托啡诺预处理对于地塞米松引起会阴部不适症状的影响

Effects of butorphanol pretreatment on dexamethasone-induced discomfort symptoms

目的探讨布托啡诺预处理对于静脉注射地塞米松磷酸钠引起会阴部不适症状的影响。方法采用前瞻性研究的方法,选择2021年6—12月在大连市妇女儿童医疗中心(集团)行妇科择期手术患者90例,按照随机数字表法分为布托啡诺0.5 mg预处理组(B1组),布托啡诺1.0 mg预处理组(B2组)和0.9%氯化钠对照组(C组)三组,每组患者30例。B1组和B2组于麻醉诱导前分别静脉注射布托啡诺0.5和1 mg,C组给予0.9%氯化钠,3 min后三组患者均给予地塞米松磷酸钠注射液10 mg,记录三组患者会阴部不适症状的发生率和分级、不良反应发生情况。结果与C组比较,B1组和B2组患者会阴部不适症状及中度会阴部不适症状发生率明显降低[20.00%(6/30)和10.00%(3/30)比60.00%(18/30)、3.33%(1/30)和3.33(1/30)比30.00%(10/30)],差异有统计学意义(P<0.05)。不良反应方面B2组头晕的发生率增多[26.67%(8/30)、10.00%(3/30)比40.00%(12/30)],差异有统计学意义(χ^(2)=7.13,P=0.028)。结论布托啡诺0.5和1.0 mg预处理都可以有效抑制静脉注射地塞米松磷酸钠引起的会阴部不适症状,但是布托啡诺0.5 mg预处理组发生的不良反应更少。

Objective To investigate the effect of pretreatment with butorphanol on perineal discomfort caused by intravenous injection of dexamethasone sodium phosphate.Methods Using the method of prospective study,ninety patients undergoing elective gynecological surgery in Dalian Women And Children's Medical Group from June to December 2021 were randomly divided into three groups:butorphanol 0.5 mg pretreatment group(group B1),butorphanol 1.0 mg pretreatment group(group B2)and normal saline control group(group C),with 30 cases in each group.Patients in groups B1 and B2 were given butorphanol 0.5 mg and 1.0 mg intravenously,respectively,prior to induction of anesthesia,while those in group C were given 0.9%sodium chloride injection.3 minutes later,all patients in the three groups were given dexamethasone sodium phosphate injection 10 mg,and the incidence,grade and adverse reactions of their perineal discomfort symptoms were recorded.Results The incidence of perineal discomfort and moderate perineal discomfort of patients in group B1 and group B2 was lower than that in group C:20.00%(6/30)and 10.00%(3/30)vs.60.00%(18/30),3.33%(1/30)and 3.33(1/30)vs.30.00%(10/30),with a statistically significant differences(P<0.05).The incidence of adverse reactions such as dizziness was increased in the group B2:26.67%(8/30)and 10.00%(3/30)vs.40.00%(12/30),with a statistically significant difference(χ^(2)=7.13,P=0.028).Conclusions Butorphanol 0.5 mg and 1.0 mg pretreatments are touted as effective in inhibiting perineal discomfort caused by intravenous injection of dexamethasone sodium phosphate.However,the butorphanol 0.5 mg pretreatment group have fewer adverse reactions.