实用医学杂志 ›› 2022, Vol. 38 ›› Issue (18): 2336-2340.doi: 10.3969/j.issn.1006⁃5725.2022.18.015

• 临床研究 • 上一篇    下一篇

不同配伍剂量的纳布啡联合氢吗啡酮对妇科腹腔镜患者术后镇痛效应的影响

孙俊枝 郭春燕 武丽芳 于建设    

  1. 内蒙古医科大学附属医院麻醉科(呼和浩特010050)

  • 出版日期:2022-09-25 发布日期:2022-09-25
  • 通讯作者: 于建设 E⁃mail:yjsmzk@163.com
  • 基金资助:
    内蒙古自然科学基金(编号:2018LH08039);内蒙古医科大学联合项目(编号:YKD2021LH015)

Effects of nalbuphine combined with hydromorphone at different compatible doses on postoperative analge⁃ sia in gynecological laparoscopic patients

SUN Junzhi,GUO Chunyan,WU Lifang,YU Jianshe.   

  1. Department of Anesthesiology,the Affiliated Hospital,Inner Mongolia Medical University,Hohhot 010050,China

  • Online:2022-09-25 Published:2022-09-25
  • Contact: YU Jianshe E⁃mail:yjsmzk@163.com

摘要:

目的 观察不同配伍剂量的纳布啡联合氢吗啡酮对妇科腹腔镜患者术后镇痛效应的 影响。方法 选择拟行妇科腹腔镜手术患者随机分成 5 组:A 组:纳布啡 0.75 mg/mL+氢吗啡酮 25 μg/mL B 组:纳布啡 0.67 mg/mL+氢吗啡酮 33 μg/mL,C 组:纳布啡 0.5 mg/mL+氢吗啡酮 50 μg/mL,D 组:纳布啡 0.33 mg/mL+氢吗啡酮 67 μg/mL,E 组:纳布啡 0.25 mg/mL+氢吗啡酮 75 μg/mL,总容量 100 mL,行经静脉自 控镇痛(PCIA)。记录患者出麻醉后监护室(PACU)及术后4、8、12、24 h 疼痛VAS评分,患者自控镇痛(PCA 次数,不良反应及镇痛满意度。结果 A 组术后 8、12、24 h 活动 VAS 评分和 PCA 按压次数明显高于其他 4 组(P < 0.05);D、E 组恶心、呕吐的发生率明显高于其他3组(P < 0.05);B、C组患者的镇痛满意度高于其 3 组(P < 0.05)。结论 纳布啡 0.67 mg/mL+氢吗啡酮 33 μg/mL 与纳布啡 0.5 mg/mL+氢吗啡酮 50 μg/mL PCIA用于妇科腹腔镜术后均可获得满意的镇痛效果,不良反应发生率最低,镇痛满意度最高,值得临床推广。

关键词:

纳布啡, 氢吗啡酮, 镇痛, 患者控制, 腹腔镜检查

Abstract:

Objective To observe the effect of nalbuphine combined with hydromorphone at different com⁃ patible dosages postoperative analgesia in gynecological laparoscopic patients. Methods The patients hospitalized in the hospital for selective laparoscopy were randomly divided into five groups according to the compatible doses nalbuphine 0.75 mg/mL + hydromorphone 25 μg/mL(Group A),nalbuphine 0.67 mg/mL + hydromorphone 33 μg/mL (Group B),nalbuphine 0.50 mg/mL + hydromorphone 50 μg/mL(Group C),nalbuphine 0.33 mg/mL + hydromor⁃ phone 67 μg/mL(Group D),nalbuphine 0.25 mg/mL + hydromorphone 75 μg/mL(Group E). VAS Pain Scores were recorded at PACU and at 4 h,8 h,12 h,24 h after operation. The total pressing times and effective pressing times of PCIA,adverse reactions and analgesic satisfaction were recorded. Results The VAS scores during activity at 8 h,12 h,24 h after operation,total pressing times and effective pressing times of PCIA in Group A were signif⁃ icantly higher than those of other groups(P < 0.05). The incidence of nausea and vomiting in groups D and group E was significantly higher than that in the other three groups(P < 0.05). The analgesic satisfaction was higher in Group B and Group C than that in the other three groups(P < 0.05). Conclusion Nalbuphine 0.67 mg/mL combined with hydromorphone 33 μg/mL and nalbuphine 0.50 mg/mL combined with hydromorphone 50 μg/mL for PCIA can obtain satisfactory analgesic effect after gynecological laparoscopic operation. The incidence of adverse reactions is the lowest and the patient′s analgesia satisfaction is the highest and therefore they are worthy of clinical application.

Key words:

nalbuphine, hydromorphone, analgesia, patient?controlled, laparoscopy