纳布啡与芬太尼用于无痛人流麻醉的效果比较

Comparison of anesthetic effect of nalbuphine and fentanyl in painless induced abortion

目的观察纳布啡、芬太尼在无痛人流的麻醉效果。方法将120例拟行无痛人流者随机分为A、B两组,每组60例。A组予纳布啡静脉注射,B组予芬太尼静脉注射。对比两组麻醉起效时间、苏醒时间、丙泊酚用量、丙泊酚追加次数;苏醒后5、15、30及60 min时的Ramsay镇静评分、视觉模拟疼痛量表(VAS)评分;麻醉前及术后2 h血清肿瘤坏死因子α(TNF-α)、白介素6(IL-6)及IL-10水平;麻醉相关不良反应的发生情况。结果 A组麻醉起效时间、苏醒时间短于B组,丙泊酚用量、丙泊酚追加次数少于B组(P<0.05或0.01);苏醒后5、15、30及60 min的Ramsay、VAS评分以及术后2 h时血清TNF-α、IL-6、IL-10水平低于B组(均P<0.05或0.01);不良反应总发生率低于B组(3.3%vs 18.3%,P<0.01)。结论与芬太尼注射液相比,在无痛人流中使用纳布啡麻醉,起效时间短,丙泊酚用量及追加次数少,患者术后苏醒快,术后疼痛程度及炎症应激反应轻,不良反应总发生率低。

Objective To observe the anesthetic effect of nalbuphine and fentanyl in painless induced abortion. Methods A total of 120 cases to undergo painless induced abortion were randomly divided into Group A and B, 60 cases in each group. Group A received intravenous injection of nalbuphine while Group B received intravenous injection of fentanyl. The two groups were compared in terms of the onset time of anesthesia, awakening time, propofol dosage and the number of propofol additions;Ramsay sedation scores and V AS scores at 5, 15, 30 and 60 min after awakening;TNF-α, IL-6 and IL-10 levels before anesthesia and 2 h after anesthesia;and the incidence of anesthesia related adverse reactions. Results The onset time of anesthesia and awakening time in Group A were shorter than those in the Control Group. The dosage of propofol and the number of propofol additions in Group A were less than those in Group B(P<0.05 or 0.01). Ramsay sedation scores and VAS scores at 5, 15, 30 and 60 min after awakening as well as the serum levels of TNF-α, IL-6 and IL-10 in Group A were lower than those in Group B(P<0.05 or 0.01). The incidence of adverse reactions in Group A was significantly lower than that in the Group B(P<0.01). Conclusion Compared with fentanyl injection, nalbuphine has better anesthetic effect in painless induced abortion with short onset time of anesthesia, less dosage of propofol and less additions of propofol, fast awakening after the operation, mild postoperative pain and inflammatory stress reactions and low incidence of adverse reactions.