Abstract：Objective To explore the application of advanced butorphanol combined with ultrasound guided multi-point block in knee replacement. Methods 108 patients who underwent knee replacement in our hospital from January 2020 to July 2022 were selected and divided into two groups (54 cases in the study group and 54 cases in the control group). Both groups were anesthetized by multi-point nerve block under the guidance of ultrasound, and the study group intravenous injection 20μg/kg butorphanol at 10 minutes before nerve block, but the equal amount of normal saline was implemented in the control group. The heart rate (HR) and mean arterial pressure (MAP) were compared before butorphanol injection (T0), 10min after butorphanol injection (T1), 15min after multi-point block (T2), 30min after multi-point block (T3) and at the end of operation (T4), and the onset and duration of pain nerve block and use of other anesthetics during operation were compared, and the scores of visual analogue scale (VAS) and Bruggrmann comfort scal (BCS) at different time points after surgery were compared, and the adverse events during and after operation were also compared. Results The HR and MAP at T1, T2 and T3 in the study group were lower than T0, which at T2 were lower than T1, and there was no statistically significant difference in pairs at other time points. The HR and MAP at T2 and T3 in the control group were lower than those at T0 and T1, but there was no statistically significant difference in pairs at other time points. There was no significant difference in HR and MAP between the two groups at each time point. Compared with the control group, the onset time of pain nerve block in the study group was short, and the duration of pain nerve block was long, while the use rate of fentanyl during operation was low. Compared with the control group, the resting VAS scores at 2h and 4h after operation in the study group were lower, while the BCS scores were higher. The rate of restlessness in the study group was lower compared with control group. Conclusion In the knee joint replacement operation, the use of butorphanol in advance combined with multi-point block under ultrasound guidance has stable blood flow during the operation and good analgesic effect, and it can reduce the short-term pain of patients after the operation, improve their comfort, and reduce restlessness during the awakening period.
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2023, Vol. 20 
