地佐辛和纳布啡在腹腔镜手术中的镇痛效果及安全性研究

Study on Analgesic Effect and Safety of Dezocine and Nalbuphine in Laparoscopic Surgery

目的探究地佐辛与纳布啡在腹腔镜手术中的镇痛效果与安全性。方法以2021年1月-2022年9月于奉新县人民医院行腹腔镜手术的86例患者为研究对象,采用随机数字表法分为地佐辛组(43例)与纳布啡组(43例),地佐辛组给予地佐辛进行围术期镇痛,纳布啡组采用纳布啡进行围术期镇痛,比较两组平均动脉压(MAP)、心率(HR)、麻醉恢复时间(自主呼吸恢复时间、睁眼时间、拔管时间)、苏醒期躁动评分、改良Aldrete评分、术后疼痛视觉模拟评分(VAS)及麻醉不良反应。结果地佐辛组缝合前、手术结束时、手术结束后10 min的MAP、HR比较,差异有统计学意义(P<0.05);纳布啡组缝合前、手术结束时、手术结束后10 min的MAP、HR比较,差异无统计学意义(P>0.05);两组手术结束时、手术结束后10 min MAP、HR比较,差异有统计学意义(P<0.05);两组自主呼吸恢复时间、睁眼时间、拔管时间比较,差异无统计学意义(P>0.05);两组拔管后15 min苏醒期躁动评分、改良Aldrete评分均高于拔管前,纳布啡组苏醒期躁动评分低于地佐辛组,改良Aldrete评分高于地佐辛组,差异有统计学意义(P<0.05);纳布啡组术后6、12 h VAS评分低于地佐辛组,差异有统计学意义(P<0.05);纳布啡组麻醉不良反应发生率低于地佐辛组,差异有统计学意义(P<0.05)。结论地佐辛与纳布啡在腹腔镜手术中均具有确切的镇痛效果,但纳布啡可减少血流动力学波动,其麻醉苏醒质量及术后镇痛效果均优于地佐辛,且麻醉不良反应风险相对更低。

Objective To explore the analgesic effect and safety of dezocine and nalbuphine in laparoscopic surgery.Methods A total of 86 patients who underwent laparoscopic surgery in the People's Hospital of Fengxin County from January 2021 to September 2022 were enrolled in the study.They were divided into dezocine group(43 patients)and nalbuphine group(43 patients)by random number table method.The dezocine group was given dezocine for perioperative analgesia,and the nalbuphine group was given nalbuphine for perioperative analgesia.The mean arterial pressure(MAP),heart rate(HR),anesthesia recovery time(spontaneous breathing recovery time,eye opening time,extubation time),emergence agitation score,modified Aldrete score,postoperative Visual Analogue Scale(VAS)and adverse reactions of anesthesia were compared between the two groups.Results There were significant differences in MAP and HR before suture,at the end of operation and 10 min after operation in the dezocine group(P<0.05).There were no significant differences in MAP and HR before suture,at the end of operation and 10 min after operation in nalbuphine group(P>0.05).There were significant differences in MAP and HR between the two groups at the end of operation and 10 min after operation(P<0.05).There was no significant difference in spontaneous breathing recovery time,eye opening time and extubation time between the two groups(P>0.05).The agitation score and modified Aldrete score of the two groups at 15 min after extubation were higher than those before extubation,while the agitation score of the nalbuphine group was lower than that of the dezocine group,and the modified Aldrete score was higher than that of the dezocine group,the difference was statistically significant(P<0.05).The VAS scores at 6 and 12 h after operation in the nalbuphine group were lower than those in the dezocine group,and the differences were statistically significant(P<0.05).The incidence of anesthesia adverse reactions in the nalbuphine group was lower than that in the dezocine group,and the difference was statistically significant(P<0.05).Conclusion Both dezocine and nalbuphine have definite analgesic effects in laparoscopic surgery,but nalbuphine can reduce hemodynamic fluctuations.Meanwhile,the quality of anesthesia recovery and postoperative analgesia are better than those of dezocine,and the risk of adverse reactions of anesthesia is relatively lower.