Pain is a common and crucial problem in clinical practice, because it has a profound influence on patients in perioperative period. Butorphanol, among plenty of analgesics, is widely used in clinical trials for its various advantages and better analgesic effects. As a typical agonist-antagonist opioid analgesic agent, butorphanol, however, shows different clinical manifestations with different affinity for opioid receptors 25∶4∶1 (κ∶μ∶δ). Besides, butorphanol provides remarkable analgesic and sedative effect in preemptive analgesia, induction and recovery period in general anesthesia, and postoperative analgesia And it could be as a adjuvant to local anaesthesia either. Compared with other opioid drugs, butorphanol is less likely to have side effect on respiratory depression. In addition, its physical dependence is extremely low.

With the further study of the ventilation model,pulmonary protective ventilation has been paid increasing attention by more and more scholars.Recent studies have shown that lung protective ventilation strategy has been proved to improve oxygenation and reduce postoperative pulmonary complications.Due to the special physiological function of the elderly,they are more likely to have postoperative pulmonary complications after mechanical ventilation.The article discusses which ventilation mode is more suitable for elderly patients undergoing laparoscopic surgery.This article reviews some theories about the physiological function of the elderly,and the effect of laparoscopy on the respiratory function of the elderly.It also reviews the related progress and controversy of low tidal volume,positive end expiratory pressure,recruitment maneuvers and other pulmonary protective strategies.

Dexmedetomidine (DEX ) is an α₂ adrenalin-receptor agonist with potent sedation, analgesia, anti-anxiety and anti-sympathetic effect. Moreover, DEX exert no inhibition of respiratory function with high safety and has considerable clinical application prospect. Children often experience emergency agitation (EA) and other uncomfortable symptom which is associated with special physical and mental state. Thus, an ideal pediatric anesthetic premedication is getting a lot of attention. DEX is superior to other premedication in sedation with high safety. Compared with others, DEX by nasal spray is an ideal drug delivery method to reduce the side effects and facilitate the implementation of the drug. The relevant research progress of the effective dose, efficacy and safety will be reviewed.