布托啡诺注射液对小儿扁桃体切除术后应激反应、苏醒期躁动及血清相关因子水平的影响

Effect of Butorphanol Injection on Stress Response,Emergence Agitation,and Serum-Related Factor Levels in Children After Tonsillectomy

目的探讨布托啡诺注射液对小儿扁桃体切除术后应激反应、苏醒期躁动及血清多巴胺(DA)、P物质(SP)、前列腺素E_(2)的影响。方法选取医院2021年6月至2023年6月收治的行扁桃体切除术的患儿120例,随机分为试验组与对照组,各60例。对照组患儿予常规麻醉,试验组患儿在对照组基础上加用布托啡诺麻醉。结果两组患儿术后的应激介质白细胞介素6、皮质醇、去甲肾上腺素水平均显著高于术前,且对照组显著高于试验组(P<0.05);对照组患儿术后的肾上腺皮质激素(ACTH)水平显著高于术前(P<0.05),试验组术后ACTH水平显著低于术前(P<0.05)。试验组患儿的苏醒时间、麻醉恢复室停留时间均显著短于对照组(P<0.05),Ramsay镇静评分显著高于对照组(P<0.05)。两组患儿术后的血清多巴胺和P物质含量均显著低于术前(P<0.05),且试验组显著高于对照组(P<0.05);试验组患儿术后的血清前列腺素E_(2)水平显著低于对照组(P<0.05)。试验组躁动总发生率为23.33%,显著低于对照组的46.67%(P<0.05)。试验组的不良反应发生率为10.00%,显著低于对照组的25.00%(P<0.05)。结论布托啡诺注射液用于小儿扁桃体切除术,能显著减轻患儿的应激反应,缩短术后麻醉苏醒时间,增强镇静效果,降低苏醒期躁动发生率,且安全性较好。

Objective To investigate the effect of Butorphanol Injection on stress response,emergence agitation,and serum dopamine(DA),substance P(SP),and prostaglandin E_(2) levels in children after tonsillectomy.Methods A total of 120 children who underwent tonsillectomy in the hospital from June 2021 to June 2023 were selected and randomly divided into the experimental group and the control group,60 cases in each group.The children in the control group were given routine anesthesia,and the children in the experimental group were given butorphanol on the basis of the control group.Results The levels of stress mediators interleukin-6,cortisol,and norepinephrine after surgery in the two groups were significantly higher than those before surgery,and those in the control group were significantly higher than those in the experimental group(P<0.05).The adrenal cortex hormone(ACTH)level after surgery in the control group was significantly higher than that before surgery(P<0.05),while that in the experimental group was significantly lower than that before surgery(P<0.05).The recovery time and post-anesthesia care unit(PACU)residence time in the experimental group were significantly shorter than those in the control group(P<0.05),while the Ramsay sedation score in the experimental group was significantly higher than that in the control group(P<0.05).The levels of serum DA and SP after surgery in the two groups were significantly lower than those before surgery(P<0.05),and those in the experimental group were significantly higher than those in the control group(P<0.05).The level of serum prostaglandin E_(2) in the experimental group was significantly lower than that in the control group after surgery(P<0.05).The total incidence of agitation in the experimental group was 23.33%,wihch was significantly lower than 46.67%in the control group(P<0.05).The incidence of adverse reactions in the experimental group was 10.00%,which was significantly lower than 25.00%in the control group(P<0.05).Conclusion Butorphanol Injection can significantly reduce the stress response of children undergoing tonsillectomy,shorten the recovery time of postoperative anesthesia,enhance the sedative effect,reduce the incidence of emergence agitation,and it has good safety.