【罂粟摘要】不同剂量布托啡诺对老年患者术后寒战的影响：一项随机、双盲、安慰剂对照试验

不同剂量布托啡诺对老年患者术后寒战的影响：一项随机、双盲、安慰剂对照试验

贵州医科大学 麻醉与心脏电生理课题组

翻译：邓举  

编辑：宋雨婷  

审校：曹莹

目的：本研究旨在探讨不同剂量的布托啡诺对老年患者术后寒战和恢复质量的影响。

受试者及方法：本研究共纳入147例老年患者（60岁或以上），计划进行择期经尿道前列腺切除术。将患者随机分为4组：C组（0.9%生理盐水）、B1组（布托啡诺0.01 mg/kg）、B2组（布托啡诺0.02 mg/kg)、B3组（布托啡诺0.03 mg/kg)。将所有药物稀释至5 mL，并在麻醉诱导前5min内缓慢静脉注射。主要结局指标是PACU术后寒战的发生率。次要结局指标为术后第1、2、3天（POD）评估恢复质量-40（QoR-40）评分，同时记录围术期核心温度、皮肤温度、拔管时间及不良事件。

结果：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（P =0.006和P=0.005）。所有布托啡诺组POD1的QoR-40评分均显著高于C组（P < 0.0083）。B2组和B3组患者的疼痛强度较小（P < 0.001）。此外，所有布托啡诺组的导尿管相关膀胱不适（CRBD）发生率均低于C组（P < 0.0083）。

结论：静脉注射布托啡诺0.02 mg/kg或0.03 mg/kg可有效预防经尿道前列腺切除术的老年患者术后发生寒战，并且可提供有效的术后恢复和术后镇痛。

原始文献来源：

Yaolin Wang, Kai Zhao, Nanling Wu,et al.Effect of Different Doses of Butorphanol on Postoperative Shivering in Elderly Patients: A Randomized, Double-Blind, Placebo-Controlled Trial［J］.Drug Design, Development and Therapy 2023:17 839–849 .

英文原文

Effect of Different Doses of Butorphanol on Postoperative Shivering in Elderly Patients: A Randomized, Double-Blind, Placebo-Controlled

Trial

Purpose  This study was designed to investigate the effects of different doses of butorphanol on postoperative shivering and quality of recovery in elderly patients. 

Patients and Methods  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.

Results  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 (P = 0.006 and P = 0.005, respectively). The QoR-40 scores on POD1 were significantly higher in all butorphanol groups than that in Group C (P < 0.0083). In Group B2 and B3, patients experienced lower pain intensity (P < 0.001). In addition, the incidence of catheter-related bladder discomfort (CRBD) was lower in all butorphanol groups than in Group C (P < 0.0083).

Conclusions  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.

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