不同剂量纳布啡联合舒芬太尼用于剖宫产术后镇痛及对TNF-α、IL-6的影响

Different Doses of Nabulphine Combined with Sufentanil Were Used for Postoperative Analgesia after Cesarean Section and the Effects on TNF-and IL-6

目的研究不同剂量纳布啡联合舒芬太尼用于剖宫产术后镇痛及对肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)的影响。方法回顾性分析2018年10月至2019年6月无锡市第八人民医院收治的160例择期行剖宫产初产妇,按照药物使用剂量的不同分为4组,每组40例。术后均行电子镇痛。C组:舒芬太尼2μg/kg;S组:舒芬太尼1.5μg/kg+纳布啡0.5 mg/kg;SN组:舒芬太尼1μg/kg+纳布啡1 mg/kg;N组:舒芬太尼0.5μg/kg+纳布啡1.5 mg/kg。比较4组术后2、4、8、12、24、48 h VAS评分,术前、术后2、4、8、12、24、48 h血清TNF-α、IL-6水平的变化,术后不良反应情况及术后镇痛总满意率。结果术后2~48 h C组、S组、SN组、N组VAS评分均呈先升后降趋势,且术后12 h时最高;与SN组和N组比较,C组、S组在术后2、4、8、12、24、48 h的VAS评分均较低;与术前相比,术后2、4、8、12、24、48 h 4组血清TNF-α、IL-6水平呈先升后降趋势,且术后24 h时最高;与C组、SN组和N组比较,S组在术后2、4、8、12、24、48 h的血清TNF-α、IL-6水平均较低;与C组比较,S组、SN组、N组产妇呼吸抑制、恶心呕吐的发生率较低;与S组比较,SN组、N组嗜睡、眩晕的发生率较高;S组的总满意率为97.50%,高于C组、SN组、N组的总满意率75.00%、87.50%、57.50%(P<0.05)。结论舒芬太尼1.5μg/kg联合纳布啡0.5 mg/kg用于剖宫产产妇术后静脉镇痛,具有良好的镇痛效果,可有效抑制炎症反应,降低不良反应,提高满意度。

Objective To investigate the effects of different doses of nalbuphine and sufentanil on postoperative analgesia and TNF-αand IL-6 in cesarean section.Method A retrospective analysis of 160 primiparous women undergoing elective cesarean section admitted to the Eighth People's Hospital of Wuxi from October 2018 to June 2019 was divided into four groups according to the different dosages of the drugs,each group of 40 people.Electronic analgesia was performed after surgery:Group C:Sufentanil 2μg/kg;Group S:Sufentanil 1.5μg/kg+Nabuphine 0.5 mg/kg;SN group:Sufentanil 1μg/kg+nalbuphine 1 mg/kg;Group N:Sufentanil 0.5μg/kg+nalbuphine 1.5 mg/kg.Compare the four groups with VAS scores at 2,4,8,12,24,and 48 h after surgery.Serum TNF-αand IL-6 levels before and after surgery at 2,4,8,12,24,and 48 h are compared.Adverse reactions and total satisfaction rate of postoperative analgesia.Results The VAS scores of group C,group S,group SN,and group N were increased first and then decreased at 2-48 hours after operation,and were highest at 12 hours after operation.Compared with group SN and group N,group C and group S were in operation The VAS scores were lower after 2,4,8,12,24,and 48 h;compared with before surgery,the serum TNF-αand IL-6 levels in the four groups increased,and then decreased at 2,4,8,12,24,and 48 hours after operation,and were highest at 24 hours after operation.Compared with the SN group and the N group,the serum TNF-αand IL-6 levels in the S group were lower at 2,4,8,12,24,and 48 hours after surgery;compared with group C,the incidence of maternal respiratory depression,nausea and vomiting was lower in groups S,SN,and N;compared with group S,the incidence of drowsiness and dizziness was higher in groups SN and N;and the overall satisfaction rate in group S It is 97.50%,which is higher than the total satisfaction rates of Groups C,SN and N:75.00%,87.50%,57.50%(P<0.05).Conclusion Sufentanil 1.5μg/kg combined with nalbuphine 0.5 mg/kg is used for intravenous analgesia after cesarean delivery.It has a good analgesic effect,can effectively suppress inflammatory reactions,reduce adverse reactions,and improve satisfaction.