纳布啡在子宫动脉栓塞术后镇痛中的应用

Application of Nalbuphine in Postoperative Analgesia After Uterine Artery Embolization

目的探讨纳布啡用于子宫动脉栓塞术后镇痛的安全性和可行性。方法选取2015年1月~2016年10月我院妇科子宫肌瘤介入手术70例,根据患者入院先后顺序,按随机数字表随机分为试验组和对照组,每组35例,选择性子宫动脉栓塞术后,常规给予静脉镇痛泵镇痛,试验组为纳布啡1 mg/kg+氟比洛芬酯100 mg,对照组为舒芬太尼2μg/kg+氟比洛芬酯100 mg,观察2组患者术后2、6、12、24、48 h疼痛视觉模拟评分(VAS)及恶心呕吐、呼吸抑制等并发症发生率。结果2组患者术后2、6、12、24 h VAS评分无统计学差异[术后2 h:(4.2±0.7)分vs.(4.0±0.5)分,t=1.375,P=0.174;术后6 h:(3.5±0.4)分vs.(3.3±0.6)分,t=1.641,P=0.105;术后12 h:(3.0±0.7)分vs.(2.8±0.5)分,t=1.375,P=0.174;术后24 h:(2.8±0.5)分vs.(2.6±0.6)分,t=1.515,P=0.134],术后48 h对照组VAS评分(2.3±0.3)分,明显高于试验组(2.1±0.4)分(t=2.366,P=0.021)。术后试验组恶心发生率明显低于对照组(22.9%vs.2.9%,χ2=4.590,P=0.032)。结论纳布啡用于子宫动脉栓塞术后镇痛,镇痛完善,能有效减少术后恶心并发症的发生。

Objective To explore the safety and feasibility of application of nalbuphine in uterine artery embolization.Methods We selected 70 cases of gynecologic fibroids receiving interventional surgery from January 2015 to October 2016 in our hospital.According to random number table,they were divided into either experimental group or control group,with 35 cases in each group.After selective uterine artery embolization,conventional intravenous analgesia pump was used to relieve pain.The experimental group was given nalbuphine 1 mg/kg and flurbiprofen 100 mg,and the control group was given sufentanil 2μg/kg and flurbiprofen 100 mg.The visual analogue scale(VAS),nausea and vomiting,respiratory depression and other complications were observed in both groups after operation at 2,6,12,24 and 48 h. Results There were no significant differences between two groups at each time point after surgery in VAS scores[2 h:(4.2±0.7)points vs.(4.0±0.5)points,t=1.375,P=0.174;6 h:(3.5±0.4)points vs.(3.3±0.6)points,t=1.641,P=0.105;12 h:(3.0±0.7)points vs.(2.8±0.5)points,t=1.375,P=0.174;24 h:(2.8±0.5)points vs.(2.6±0.6)points,t=1.515,P=0.134].At 48 h after operation,the VAS score was significantly higher in the control group than that in the experimental group[(2.3±0.3)points vs.(2.1±0.4)points,t=2.366,P=0.021].The incidence of nausea in the experimental group was lower than that in the control group(22.9%vs.2.9%,χ2=4.590,P=0.032).Conclusion Use of nalbuphine for analgesia after uterine artery embolization has good analgesic results and reduces the incidence of nausea and vomiting after operation.