纳布啡用于小儿尿道下裂成形术术后镇痛临床研究

The Postoperative Analgesic Effect of Nalbuphine in Pediatric Patient Undergoing Hypospadias Surgery

观察纳布啡用于小儿尿道下裂成形术术后镇痛临床效果。择期行尿道下裂成形术小儿90例随机均分为纳布啡(N)组、氟比洛芬酯(F)组和空白对照(C)组,所有小儿术后采用静脉自控镇痛,三组剂量分别为纳布啡1mg/kg+舒芬太尼2.0μg/kg、氟比洛芬酯2mg/kg+舒芬太尼2.0μg/kg和舒芬太尼2.0μg/kg。观察并记录小儿术后4h(T_1)、8h(T_2)、12h(T_3)、24h(T_4)时心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SpO_2)、呼吸频率(RR)及CHEOPS疼痛评分和Ramsay镇静评分,记录不良反应发生情况。与C组相比,N组、F组各时间点CHEOPS评分降低(P<0.05);N组Ramsay镇静评分低于F组和C组(P<0.05),C组不良反应发生率明显高于N组和F组(P<0.05)。纳布啡可安全用于小儿尿道下裂成形术,术后镇痛镇静效果满意且不良反应少。

To observe the postoperative analgesia of nalbuphine in pediatric patient undergoing hypospadias surgery ninety pediatric scheduled for hypospadias surgery were randomly divided into three groups（n=30 each）：nalbuphine（N）group,flurbiprofen axetil（F）group and blank control（C）group.Postoperative patient-controlled intravenous analgesia（PCIA）was given in all groups.The drugs for PCIA in group N,group F,group C：nabuphine 1 mg/kg ＋ sufentanil 2.0μg/kg,Flurbiprofen axetil 2 mg/kg ＋ sufentanil 2.0μg/kg,sufentanil 2.5μg/kg.children,HR,MAP,SpO2,RR,CHEOPS scores and Ramsay scores were assessed at 4 h（T1）,8 h（T2）,12 h（T3）,24 h（T4）postoperatively.The time when children started to press the PCA,and the incidence of nausea,vomiting were also assessed.All the children received a PCIA analgesia effectively,but compared with the group C,CHEOPS scales were significantly lower in group N and group F（P〈0.05）;Compared with group F and group C,Ramsay scales were significantly lower in group N（P〈0.05）;The incidence of side effect in the group C were higher than the other two groups（P〈0.05）.Nalbuphine for postoperative intravenous analgesia（PCA）is effective and safe in pediatric undergoing hypospadias surgery,and it has effective postoperative analgesia and less side effects.