等效剂量纳布啡与舒芬太尼用于剖宫产术后PCIA比较

Comparison of equivalent dose of nalbuphine and sufentanil in patient-controlled intravenous analgesia after cesarean section

目的:观察纳布啡用于剖宫产术后自控静脉镇痛95%有效剂量,并与等效剂量舒芬太尼镇痛比较。方法:选取80例拟于某医院行剖宫产术产妇。先纳入20例产妇验证纳布啡在剖宫产术后行PCIA的95%有效剂量(ED95),随后纳入60例产妇,随机分为纳布啡组(观察组)或舒芬太尼组(对照组),每组30例。观察组配置纳布啡ED95剂量,对照组配置等效剂量的舒芬太尼,对两种不同药物产生的镇痛效果进行分析探究。结果:纳布啡用于剖宫产术后PCIA的ED95为2.259 mg/kg(95%CI:2.106~4.055 mg/kg)。依据ED95观察组产妇PCIA配置纳布啡剂量为2.259 mg/kg;对照组产妇PCIA配置舒芬太尼剂量为2.259 ug/kg。观察组产妇术后4 h宫缩痛VAS评分明显低于对照组,且术后24 h、36 h镇静评分明显高于对照组,差异有统计学意义(P<0.05)。观察组产妇的术后镇痛相关不良反应总发生率较对照组明显更低(P<0.05);观察组产妇的满意度高于对照组(P<0.05)。结论:纳布啡用于剖宫产术后自控静脉镇痛的95%有效剂量为2.259 mg/kg,相比较等效的舒芬太尼,纳布啡对宫缩痛的抑制及镇静效果较好,且不良反应发生率低。

Objective:To observe the 95%effective dose of nalbuphine for patient-controlled intravenous analgesia(PCIA)after cesarean section and compare it with the equivalent dose of sufentanil.Methods:A total of eighty parturients who planned to undergo cesarean section in hospital were selected.Twenty parturients were enrolled to verify the 95%effective dose(ED95)of nalbuphine during PCIA after cesarean section.Sixty parturients were then randomly assigned to either the nalbuphine group(observation group)or the sufentanil group(control group),with thirty parturients in each group.The observation group received the dose of nalbuphine ED95,and the control group was given the equivalent dose of sufentanil.The analgesic effects of two different drugs were analyzed and explored.Results:The results showed that the ED95 of nalbuphine for PCIA after cesarean section was 2.259 mg/kg(95%CI:2.106~4.055 mg/kg).According to the calculation of ED95,the dose of nalbuphine for PCIA in the observation group was 2.259 mg/kg.The PCIA dose of sufentanil in the control group was 2.259 ug/kg.The VAS score of the observation group was significantly lower than that of the control group at 4 h after operation,and the sedation score at 24 h and 36 h after operation was significantly higher than that of the control group(P<0.05).The statistics of adverse reactions related to postoperative analgesia of parturients showed that the incidence of total adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).The satisfaction of the observation group was higher than that of the control group(P<0.05).Conclusion:The 95%effective dose of nalbuphine for PCIA after cesarean section was 2.259 mg/kg.Compared with the equivalent sufentanil,nalbuphine has a better inhibitory and sedative effect on uterine contraction pain,and the incidence of adverse reactions is lower.