Abstract：Objective To investigate the efficacy and safety of Dexmedetomidine combined with Butorphanol for postoperative analgesia in patients with microvascular decompression. Methods A total of 40 patients scheduled for microvascular decompression in Hunan Brain Hospital from January 2019 to December 2020 were selected, they were divided into Butorphanol group (group C) and Butorphanol combined with Dexmedetomidine group (Group D) according to the random number table method, with 20 cases in each group. Patient controlled intravenous analgesia was performed after operation. Group C received Butorphanol 10 mg + Tropisetron 5 mg, and group D received Butorphanol 10 mg + Dexmedetomidine 200 μg + Tropisetron 5 mg, diluted to 100 ml with normal saline. The mean arterial pressure (MAP) and heart rate (HR) of both groups were recorded before operation (T0) and after operation at 4 h (T1), 12 h (T2), 24 h (T3), and 48 h (T4); visual analogue scale (VAS) score and Ramsay sedation score were recorded after T1-T4 in both groups; adverse reactions and sleep quality scores were recorded. Results In group C, MAP values at T1-T2 were higher than those at T0, and MAP values at T3-T4 were lower than those at T1-T2, and the differences were statistically significant (P < 0.05). MAP values of group D at T2-T4 were lower than those at T1, and the differences were statistically significant (P < 0.05). MAP values of group D at T1-T4 were lower than those of group C, and the differences were statistically significant (P < 0.05). In group C, HR values at T2-T4 were lower than those at T0 and T1, and the differences were statistically significant (P < 0.05). In group D, HR values at T2-T4 were lower than those at T0 and T1, while HR value at T4 was higher than that at T3, and the differences were statistically significant (P < 0.05). HR values of group D at T1-T4 were lower than those of group C, and the differences were statistically significant (P < 0.05). There were statistically significant differences in the resting and active VAS scores in group C at each time points (P < 0.05). In group D, the resting VAS scores at T2-T3 were lower than those at T1, and the resting VAS score at T4 was lower than that at T1-T3, and the differences were statistically significant (P < 0.05); there were statistical significances in active VAS score in group D at each time points (P < 0.05). The resting and active VAS scores of group D at T1-T4 were lower than those of group C, and the differences were statistically significant (P < 0.05). Ramsay sedation scores in group D at T1-T4 were higher than those in group C, and the differences were statistically significant (P < 0.05). The total incidence of adverse reactions in group D was lower than that in group C, and the difference was statistically significant (P < 0.05). There was no significant difference in sleep quality before and after operation in group C (P > 0.05); the sleep quality of group D after operation was better than that before operation, and the difference was statistically significant (P < 0.05). Sleep quality of group D after operation was better than that of group C, and the difference was statistically significant (P < 0.05). Conclusion Dexmedetomidine combined with Butorphanol for postoperative analgesia after microvascular decompression is safe and effective. It can provide good sedative and analgesic effect, improve sleep quality and reduce adverse reactions.
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