纳布啡复合舒芬太尼自控静脉镇痛对老年患者开腹术后应激反应及疼痛的影响

Effects of patient-controlled intravenous analgesia of nalbuphine combined with sufentanil on stress response and pain after laparotomy in elderly patients

目的分析纳布啡复合舒芬太尼自控静脉镇痛(PCIA)对老年患者开腹术后应激反应与疼痛的影响。方法将90例行开腹术的老年患者按简单随机化方式分为对照组(n=44)和研究组(n=46)。对照组使用舒芬太尼PCIA,研究组在对照组基础上加用纳布啡。比较两组术前、术后24 h应激反应指标水平、术后不同时刻疼痛情况及不良反应发生情况。结果术后24 h,两组EP、NE、COR水平均高于术前,但研究组低于对照组(P<0.05)。研究组术后4、8、12 h的NRS评分均低于对照组(P<0.05)。两组均无显著不良反应。结论纳布啡复合舒芬太尼PCIA可减轻老年患者开腹术后应激反应与疼痛,且安全性高。

Objective To analyze the effects of patient-controlled intravenous analgesia(PCIA) of nalbuphine combined with sufentanil on stress response and pain after laparotomy in elderly patients. Methods Ninety elderly patients who underwent laparotomy were divided into control group(n =44) and study group(n =46) according to simple randomized method. The control group was treated with PCIA of sufentanil, while the study group was added nalbuphine on the basis of the control group. The levels of stress response indexes before operation and at 24 hours after operation, pain at different time after operation and adverse reactions were compared between the two groups. Results At 24 hours after operation, the levels of EP, NE and COR in the two groups were higher than those before operation, but those in the study group were lower than the control group(P<0.05). The NRS scores of the study group at 4, 8 and 12 hours after operation were lower than those of the control group(P<0.05). There were no significant adverse reactions in both groups. Conclusion The PCIA of nalbuphine combined with sufentanil can alleviate the stress response and pain after laparotomy in the elderly patients,with high security.