不同剂量纳布啡复合舒芬太尼在儿童腹腔镜手术患者术后镇痛中的应用观察

Application of different doses of nalbuphine combined with sufentanil in postoperative analgesia of children with laparoscopic surgery

目的研究不同剂量的纳布啡复合舒芬太尼在儿童腹腔镜手术术后镇痛中的应用效果.方法将广东省惠州市第二妇幼保健院2019年5月-2021年5月收治的102例行腹腔镜手术的患儿随机分为A(51例)、B(51例)两组,所有患儿均由同组医师进行手术,均使用相同麻醉药物和麻醉方式,两组患儿均在此基础上进行药物镇痛,其中A组患儿使用0.1mg/kg纳布啡加适量舒芬太尼进行术后镇痛;B组患儿使用0.2mg/kg纳布啡加适量舒芬太尼进行术后镇痛.术后0.5h、1h、2h、4h、8h时比较两组患儿疼痛度(FLACC疼痛评分)和镇静度[Ramsay镇静评分(RSS)].比较两组患儿术后镇痛效果持续时间、麻醉恢复室(PACU)停留时间、追加镇痛给药次数.比较两组患儿住院期间不良反应(呼吸控制、瘙痒、恶心呕吐)发生率.结果两组患儿术后0.5h、1h、2h时,FLACC、RSS评分比较,均无明显差异(P>0.05),但术后4h、8h时,B组FLACC评分明显低于同时间A组(P<0.05),RSS评分明显高于同时间A组(P<0.05);两组患儿手术期间PACU停留时间、追加镇痛给药次数比较,无明显差异(P>0.05),但B组镇痛效果持续时间明显大于同时间A组(P<0.05);两组患儿术后不良反应总发生率无明显差异(P>0.05).结论在进行儿童腹腔镜手术镇痛时,使用0.2mg/kg纳布啡联合舒芬太尼的镇痛、镇静效果更好,且对呼吸控制、恶心呕吐、瘙痒预防有一定效果.

Objective To study the application ffeet of dfferent doses of nalbuphine combined with sufentanil in the postoperative analgesia of children with laparoscopie surgery Methods 102 children who underwent laparoscopie surgery in the hospital between May 2019 and May 2021 were randomly divided into group A(51 cases)and group B(51 cases).All children underwent surgery by the same group of physicians and with the same anesthetie drugs and anesthesia methods.Both groups of children were given drug analgesia on this basis,and the children in group A reved 0.1mgkg of nalbuphine and ppopriale anount of sufenanil for postoperaive analgsiand the children in group B were given 0.2mg/kg of nalbuphine and appropriate amount of sufentanil for postoperative analgesia.Pain(FLACC Pain Score)and sedation[Ramsay Sedation Score(RSS)]at 0.5h,Ih,2h,4h and 8h after surgery,duration of postoperative analgesic effct,postanesthesia care unit(PACU)stay and frequency of additional analgesie administration were compared between the two groups.The ineidence rates of adverse reactions(respiratory control,pruritus,nausea and vomiting)of the two groups were compared during hospitalization.Results There were no significant diferences in the scores of FLACC and RSS between the Iwo groups of children at 0.5h,Ih and 2h after surgery (P>0.05),but at 4h and 8h after surgery,the FLACC score of group B was significanly lower than that ol group A(P<0.05)while the RSS score was signifeantly higher than that of group A(P<0.05).There were no significant differences in PACU stay and frequency of aditional analgesic admistration betveen the two groups of children during surgery(P>0.05),but the duration of analgsic efet in group B was significantly longer than that in group A(P<0.05).There was no sgnificant dfference in the total ineidence rate of adverse reactions between the two groups of children(P>0.05).Conclusion When performing analgesia in laparoscopic surgery of children,the application of 0.2 mg/kg of nalbuphine combined with sufentanil has better analgesic and sedative eets.and has a certain effect on respiratory control,nausea and vomiting and prurius prevention.