Clinical research of dezocine combined butorphanol for postoperative analgesia in elderly patients

Abstract

Objective To observe the effect of combined dezocine with butorphanol for postoperative analgesia in elderly patients. Methods Totally 40 patients older than 65 years under general anesthesia for abdominal radical resection of gastric cancer or thoracic esophageal cancer or cardia carcinoma radical resection were randomly divided into combined dezocine with butorphanol group (group I) and butorphanol group (group II), 20 cases of each group. Before operation, phenobarbita 0.1 g and atropine 0.5 mg im. The operations were under total intravenous anesthesia with endotracheal intubation and mechanical ventilation. Propofol, remifentanil and cisatracurium maintain anesthesia. Thirty minutes before the end of operation, analgesic load dose was given and opened the analgesia pump. Group I: dezocine 25 mg, butorphanol 8 mg and granisetron hydrochloride 3 mg.group Ⅱ: butorphanol 13 mg and granisetron hydrochloride 3 mg.The volume was diluted with saline to 150 ml. Continuous intravenous infusion velocity was 3 ml/h.Bolus dose was 3 ml/time, lock time was 15 min and maximum dose was 9 ml/h. The time of recovery and extubation were recorded. VAS score was used to assess pain, nausea and vomiting; Ramsay score was used to evaluate the degree of sedation; Cognitive functions were evaluated with MMSE scale. Results 48 h postoperatively, VAS score of group I (1.75±0.44) was lower than that of group Ⅱ(2.25±0.79) (P<0.05). 6 h postoperatively, sedation score of group Ⅱ(3.75±0.79)was higher than that of group I(2.15±0.75) (P<0.05). 48 h postoperatively, nausea and vomiting scores of group I (0) was lower than that of group Ⅱ(0.70 ±1.30)(P<0.05). Compared with the MMSE score at 1 d postoperatively, the MMSE scores of two groups decreased at 6 h postoperatively, and the MMSE score of group Ⅱ(15.00±2.00) was lower than that of group I(20.95±1.54)(P<0.05). Conclusion Intravenous dezocine combined butorphanol for postoperative analgesia in elderly patients is safe, and the side effects are less than that of the pure butorphanol analgesia. Key words: Dezocine; Butorphanol; The elderly; Postoperative analgesia