Effects of butorphanol preadministration in the prevention of myocardial injury induced by ischemia-reperfusion in patients with distal fracture of lower extremities

Objective To analyze the clinical value of butorphanol preadministration in the prevention of myocardial injury induced by ischemia-reperfusion in patients with distal fracture of lower extremities. Methods Ninety patients with distal fracture of lower extremities treated by ischemia-reperfusion in the Second Hospital of Shanxi Medical University from June 2018 to February 2019 were selected as subjects of the study. The patients were divided into observation group and control group according to random number table method, with 45 cases in each group. Patients in observation group were pretreated with butorphanol during the operation, and patients in control group were injected with the same dose of physiological sodium chloride solution intravenously. Perioperative indicators of the two groups were compared. The levels of creatine kinase isoenzymes (CK-MB), malondialdehyde (MDA), cardiac troponin I (cTnI) and tumor necrosis factor-α (TNF-α) before tourniquet use and after tourniquet release were compared between the two groups. Results There was no significant difference in operation time between the two groups (P>0.05). The time of intraoperative tourniquet use and hospitalization of observation group were significantly shorter than those of control group (P<0.05). In control group, the levels of CK-MB, MDA, cTnI, TNF-α at 5 min, 2 h, 12 h and 24 h after the release of tourniquet were significantly higher than those before using tourniquet (P<0.05). In observation group, CK-MB was higher at 5 min, 2 h, 12 h and 24 h after the release of tourniquet than that before tourniquet use (P<0.05), but there was no significant difference in MDA, cTnI and TNF-α before tourniquet use and 24 hours after tourniquet release. CK-MB, MDA, cTnI and TNF-α in observation group were lower than those in control group before tourniquet use and 5 min, 2 h, 12 h and 24 h after tourniquet release (P<0.05). Conclusions Preadministration of butorphanol has a protective effect on myocardial injury induced by ischemia-reperfusion in patients with distal fracture of lower extremities. Key words: Distal fracture of lower extremities; Ischemia-reperfusion; Butorphanol; Myocardial injury