纳布啡给药时机对小儿鼾症手术苏醒质量的影响

Effect of different administration for Nalbuphine on recovery period of Children Snoring Disease Operation

目的探讨纳布啡给药时机对小儿鼾症手术苏醒质量的影响。方法选取南方医科大学顺德医院2020年1月至9月收治的84例全身麻醉下行小儿鼾症手术的患者作为研究对象,根据不同给药时机分为超前镇痛组和术后镇痛组,每组42例。超前镇痛组患者于手术开始前5 min给予纳布啡(0.1 mg/kg),术后镇痛组患者于手术结束前5 min给予纳布啡(0.1 mg/kg)。记录两组患者围手术期各时间点生命体征、躁动情况和疼痛程度。结果术后镇痛组患者在手术开始时,HR和MAP均明显上升(P<0.05)。术后镇痛组患者镇静躁动评分(sedation agitation scale,SAS)和东大略儿童医院疼痛评分(Childrens'Hospital Eastern Ontario Pain Scale,CHEOPS)在大部分时间点均明显高于超前镇痛组(P<0.05)。超前镇痛组不良反应1例,术后镇痛组不良反应2例,差异无统计学意义(P>0.05)。结论纳布啡超前镇痛能安全用于小儿鼾症手术的围术期镇痛管理,可更有效缓解苏醒期躁动和术后疼痛,缩短拔管时间和苏醒时间,且不良反应发生率低。

Objective To explore the effect of different administration for nalbuphine on the quality of recovery after operation in children with snoring.Methods 84 children undergoing snoring disease operation under general anesthesia from January 2020 to Septemper 2020 in Shunde Hospital of Southern Medical University were selected and randomly divided into the Group Preemptive analgesia and Group Postoperative analgesia,42 cases each group.In group P,0.1 mg/kg of nalbuphine was given 5 minutes before the beginning of operation.And in group S,0.1 mg/kg of nalbuphine was given 5 minutes before the end of operation.Record the vital signs of the two groups at each time point and adverse reactions were recorded.Record the restlessness and pain of the two groups at different time points after operation.Results At the beginning of operation,HR and MAP in group S increased significantly(P<0.05).What's more,SAS agitation score and CHOPS pain score in group S were significantly higher than those in group P at most time points(P<0.05).The incidence of adverse reactions in both two groups was low(P>0.05).Conclusion Nalbuphine can safely be used in perioperative analgesia management of children snoring operation by preemptive analgesia.It could effectively relieve restlessness and postoperative pain,shorten extubation time and recovery time,and has low incidence of adverse reactions.