Using Preoperative Anxiety Score to Determine the Precise Dose of Butorphanol for Sedation

Using Pre-operative Anxiety Score to Determine the Precise Dose of Butorphanol in Patients Undergoing Orthopedic Procedures: A Double-blinded Randomized Trial

Pre-operative anxiety usually lead to increased anesthetics during the surgery. The precise sedative requirement which can keep adequate sedative state and avoid adverse effects caused by excessive drugs still needs further study. Therefore, our purpose was to confirm the sedative effect of butorphanol and to explore the relationship between pre-operative anxiety and intra-operative butorphanol requirement to evaluate the precise sedative requirement which can keep adequate sedation for patients by pre-operative anxiety score.

A total of 142 patients (aged 18-75 years) who were scheduled for elective low limb orthopedic procedures under spinal anesthesia were included in this study. Patients were divided into two groups based on pre-operative anxiety score evaluated by the Amsterdam pre-operative anxiety and information scale before the surgery. And intramuscular midazolam 0.05mg/kg as a premedication in preoperative room was given to patients before shifting into operation room. Patients in each group were randomly divided into butorphanol group and 0.9% saline group. The sedation score, the duration of reaching adequate sedation state and postoperative recovery were recorded.

Inclusion Criteria:

• ASA Ⅰ-Ⅱ
• age 18-75 years
• surgical operation of lower extremities in orthopedics
• no contraindication of epidural anesthesia

Exclusion Criteria:

• with central system disease
• with cardiovascular disease
• with autonomic nervous system disease
• long term use of analgesic drugs ,sedative drugs,and anti-anxiety drugs
• language barrier
• unwilling to cooperate with the experimenter