不同配伍剂量的纳布啡联合氢吗啡酮对妇科腹腔镜患者术后镇痛效应的影响

Effects of nalbuphine combined with hydromorphone at different compatible doses on postoperative analgesia in gynecological laparoscopic patients

目的观察不同配伍剂量的纳布啡联合氢吗啡酮对妇科腹腔镜患者术后镇痛效应的影响。方法选择拟行妇科腹腔镜手术患者随机分成5组:A组:纳布啡0.75 mg/mL+氢吗啡酮25μg/mL,B组:纳布啡0.67 mg/mL+氢吗啡酮33μg/mL,C组:纳布啡0.5 mg/mL+氢吗啡酮50μg/mL,D组:纳布啡0.33 mg/mL+氢吗啡酮67μg/mL,E组:纳布啡0.25 mg/mL+氢吗啡酮75μg/mL,总容量100 mL,行经静脉自控镇痛(PCIA)。记录患者出麻醉后监护室(PACU)及术后4、8、12、24 h疼痛VAS评分,患者自控镇痛(PCA)次数,不良反应及镇痛满意度。结果A组术后8、12、24 h活动VAS评分和PCA按压次数明显高于其他4组(P<0.05);D、E组恶心、呕吐的发生率明显高于其他3组(P<0.05);B、C组患者的镇痛满意度高于其他3组(P<0.05)。结论纳布啡0.67 mg/mL+氢吗啡酮33μg/mL与纳布啡0.5 mg/mL+氢吗啡酮50μg/mL PCIA用于妇科腹腔镜术后均可获得满意的镇痛效果,不良反应发生率最低,镇痛满意度最高,值得临床推广。

Objective To observe the effect of nalbuphine combined with hydromorphone at different com⁃patible dosages postoperative analgesia in gynecological laparoscopic patients.Methods The patients hospitalized in the hospital for selective laparoscopy were randomly divided into five groups according to the compatible doses:nalbuphine 0.75 mg/mL+hydromorphone 25μg/mL(Group A),nalbuphine 0.67 mg/mL+hydromorphone 33μg/mL(Group B),nalbuphine 0.50 mg/mL+hydromorphone 50μg/mL(Group C),nalbuphine 0.33 mg/mL+hydromor⁃phone 67μg/mL(Group D),nalbuphine 0.25 mg/mL+hydromorphone 75μg/mL(Group E).VAS Pain Scores were recorded at PACU and at 4 h,8 h,12 h,24 h after operation.The total pressing times and effective pressing times of PCIA,adverse reactions and analgesic satisfaction were recorded.Results The VAS scores during activity at 8 h,12 h,24 h after operation,total pressing times and effective pressing times of PCIA in Group A were signif⁃icantly higher than those of other groups(P<0.05).The incidence of nausea and vomiting in groups D and group E was significantly higher than that in the other three groups(P<0.05).The analgesic satisfaction was higher in Group B and Group C than that in the other three groups(P<0.05).Conclusion Nalbuphine 0.67 mg/mL combined with hydromorphone 33μg/mL and nalbuphine 0.50 mg/mL combined with hydromorphone 50μg/mL for PCIA can obtain satisfactory analgesic effect after gynecological laparoscopic operation.The incidence of adverse reactions is the lowest and the patient′s analgesia satisfaction is the highest and therefore they are worthy of clinical application.