Abstract：【Objective】 To explore the effects of dexmedetomidine (Dex) combined with butorphanol on postoperative analgesia and oxidative stress response in patients undergoing esophagectomy.【Methods】 A total of 102 patients undergoing esophagectomy were randomly divided into a control group and an observation group, with 51 patients in each group. The control group received postoperative analgesia with butorphanol and sufentanil, while the observation group received butorphanol combined with Dex. Awakening time, hemodynamic parameters [heart rate (HR), mean arterial pressure (MAP)], stress response markers [adrenaline (Adr), cortisol (Cor)], pain levels, and adverse reactions were compared between the two groups.【Results】The awakening time and postoperative recovery room stay in the observation group were shorter than those in the control group (P<0.05). In both groups, HR and MAP at 6 minutes after anesthesia (T1) and 2 minutes after surgery (T2) were higher than those before anesthesia (T0) (P<0.05), while HR and MAP at T2 were lower than those at T1 (P<0.05). HR and MAP at T1 and T2 were significantly lower in the observation group compared to the control group (P<0.05). Adr and Cor levels at 24 hours and 36 hours postoperatively were higher than preoperative levels in both groups (P<0.05), with levels at 36 hours showing lower than those at 24 hours (P<0.05). The observation group had significantly lower Adr and Cor levels at 24 hours and 36 hours postoperatively compared to the control group (P<0.05). Visual Analog Scale (VAS) scores at 3, 9, 24, and 36 hours postoperatively were higher than preoperative levels in both groups (P<0.05), showing an initial increase followed by a decrease. The VAS scores of the observation group at each time period after surgery were lower than those of the control group (P<0.05). There was no statistically significant difference in the overall incidence of adverse reactions between the two groups (P>0.05).【Conclusion】 Dex combined with butorphanol in esophagectomy stabilizes postoperative hemodynamic parameters, accelerates patient recovery, suppresses perioperative stress response, reduces postoperative pain, and demonstrates good safety.
李现虎, 郭聪, 王玉瑶. 右美托咪定复合布托啡诺对食管癌根治术患者术后镇痛的效果及氧化应激反应的影响[J]. 医学临床研究, 2024, 41(10): 1505-1507.
LI Xianhu, GUO Cong, WANG Yuyao. Effects of Dexmedetomidine Combined with Butorphanol on Postoperative Analgesia and Oxidative Stress Response in Patients Undergoing Esophagectomy. JOURNAL OF CLINICAL RESEARCH, 2024, 41(10): 1505-1507.
[1] BHATT A, KAMATH S, MURTHY S C, et al. Multidisciplinary evaluation and management of early stage esophageal cancer[J].Surg Oncol Clin N Am,2020,29(4):613-630.
[2] WANG C, LI L, XU H, et al. Effect of desflurane-remifentanil or sevoflurane-remifentanil on early recovery in elderly patients: a meta-analysis of randomized controlled trials[J].Pharmazie, 2019,74(4):201-205.
[3] LIAO M, XIA Z, HUANG P, et al. Early enteral feeding on esophageal cancer patients after esophageal resection and reconstruction[J].Ann Palliat Med,2020,9(3):816-823.
[4] IRIARTE F, SU S, PETROV R V, et al. Surgical Management of Early Esophageal Cancer[J].Surg Clin North Am,2021,101(3):427-441.
[5] 朱咏仪, 张雷, 赵年章,等. 布托啡诺用于经腹腔镜子宫肌瘤剔除术患者术后睡眠质量的效果观察[J].武警后勤学院学报(医学版),2021, 30(4):3-5.
[6] XU Q L, LI H, ZHU Y J, et al. The treatments and postoperative complications of esophageal cancer: a review[J].J Card Surg,2020,15(1):163-168.
[7] WANG T C, FENG Y, ZHAO Z, et al. IL1RN polymorphisms are associated with a decreased risk of esophageal cancer susceptibility in a chinese population[J].Chemotherapy,2019,64(1):28-35.
[8] WANG Y B, CHENG J, YANG L, et al. Ropivacaine for intercostal nerve block improves early postoperative cognitive dysfunction in patients following thoracotomy for esophageal cancer[J].Med Sci Monit,2019,25(18):460-465.
[9] SUDARSHAN M, RAJA S. Commentary: Take your time but quickly! Impact of time to surgery in early esophageal cancer[J].J Thorac Cardiovasc Surg,2020,159(4):1636.
[10] JONES T, BRACAMONTE J L, AMBROS B, et al. Total intravenous anesthesia with alfaxalone, dexmedetomidine and remifentanil in healthy foals undergoing abdominal surgery[J].Vet Anaesth Analg,2019, 46(3):315-324.
[11] 陈媛, 曹苏. 右美托咪定复合布托啡诺对胃癌微创手术患者的镇痛效果[J].医学临床研究, 2019, 36(12):2455-2456.
[12] 张晓丰, 宋子晨, 张春璐, 等. 酒石酸布托啡诺复合罗哌卡因双侧腹横肌平面阻滞及腹直肌鞘阻滞对腹腔镜胆囊切除术术后疼痛控制效果的比较[J].中国实验诊断学, 2021, 25(1):2-4.
[13] 赵惠, 党文培, 邹丽娟, 等. 右美托咪定与布托啡诺联合用药的临床应用[J].医药导报, 2022,5(4):41-43.
[14] KISKI D , MALEC E , SCHMIDT C . Use of dexmedetomidine in pediatric cardiac anesthesia[J].Curr Opin Anaesthesiol,2019, 32(3):334-342.
2024, Vol. 41 
