舒芬太尼复合小剂量纳美芬对术后静脉自控镇痛效能的作用

Effects of Sufentanil Combined with Low Dose of Nalmefene on Postoperative Intravenous Analgesia and Gastrointestinal Motility in Patients with PCIA

目的:观察舒芬太尼复合小剂量纳美芬用于术后静脉自控镇痛效果和对胃肠动力变化的影响。方法:选择全麻术后静脉自控镇痛患者58例,按照随机数字表法随机分为2组,对照组(舒芬太尼组)镇痛泵配方为舒芬太尼2μg/kg、氟哌利多2.5 mg稀释至100 mL,纳美芬组(纳美芬-舒芬太尼组)在对照组基础上加纳美芬0.5μg/kg。结果:与对照组相比,纳美芬组恶心呕吐发生率明显降低,首次排气时间明显缩短(P<0.05)。结论:小剂量纳美芬可增强镇痛效果,减少舒芬太尼术后镇痛恶心呕吐发生率,同时促进肠蠕动恢复。

Objective To observe the effects of sufentanil combined with ultra-small doses of nalmefene on postoperative intravenous analgesic effects and gastrointestinal motility changes. Methods Fifty eight pa-tients with intravenous controlled analgesia （PCIA） after general anesthesia were randomly divided into control group and nalmefene group according to random numeric table ,and each group had 29 patients. Analgesia pump formulations for the control group （sufentanil group） was infused with sufentanil 50 μg＋droperidol 2 mg＋saline diluted to 100 mL. nalmefene group （nalmefene-sufentanil group） used sufentanil plus nalmefene 0.5 μg/kg on the basis of the control group. VAS pain score and adverse events （nausea, vomiting, itching and respiratory de-pression）, exhaust time for the first time 24 hours after operation, and plasma motilin level were detected during postoperative 48 h. Results Both groups made good analgesic effect,but nalmefene group was significantly bet-ter than the control group.Compared with control group, the incidence of nausea and vomiting in the nalmefene group, was significantly reduced, the time of first exhaustion was significantly shortened with statistically signifi-cant difference （P〈0.05）. Compared with preoperation, the motilin levels in both groups were elevated; com-pared with control group, the secretion peak in nalmefene group was significantly delayed. Conclusion Low dose nalmefene may enhance the analgesic effect , reduce the incidence of postoperative nausea and vomiting caused by sufentanil , as well as promote the recovery of bowel movements.