纳布啡联合腹横肌平面阻滞在子宫肌瘤术后镇痛中的应用效果分析

Effect of Nalbuphine Combined with Transverse Abdominal Muscle Plane Block in Postoperative Analgesia of Uter-ine Fibroids

目的:探讨纳布啡联合腹横肌平面阻滞(TAPB)在子宫肌瘤术后镇痛中的应用效果。方法:选取2020年6月—2022年6月于鄂州市鄂钢医院行手术治疗的子宫肌瘤患者130例作为研究对象,随机分为对照组与观察组,各65例。对照组采用常规镇痛药物联合TAPB进行术后静脉自控镇痛(PCIA),观察组采用纳布啡联合TAPB进行PCIA。评估术后2 h(T_(0))、术后24 h(T_(1))、术后48 h(T_(2))两组患者疼痛感受[视觉模拟疼痛评分(VAS)]与镇静状态[Ramsay镇静评分]差异,统计两组患者镇痛药物用量与自控镇痛次数、不良反应发生率。结果:T_(1)、T_(2)时,两组患者VAS、Ramsay镇静评分低于T_(0)时,两组T_(2)时VAS、Ramsay镇静评分低于T_(1)时,差异有统计学意义(P<0.05);T_(0)、T_(1)、T_(2)各时间点观察组VAS评分均低于对照组,Ramsay镇静评分均高于对照组,差异有统计学意义(P<0.05)。观察组术后镇痛药物用量、自控镇痛次数均低于对照组,差异有统计学意义(P<0.001);观察组不良反应发生率低于对照组,差异有统计学意义(P=0.041)。结论:纳布啡联合TAPB在子宫肌瘤术后镇痛中具有积极的应用效果,可有效提高镇痛、镇静作用,减少患者镇痛药物依赖,降低不良反应发生率。

Objective:To investigate the effect of nalbuphine combined with transverse abdominal muscle plane block(TAPB)in postoperative analgesia of uterine fibroids.Methods:A total of one hundred and thirty patients with uterine fibroids who underwent surgical treatment in Ezhou Egang Hospital from June 2020 to June 2022 were selected as the study objects and randomly divided into control group and observation group,with sixty-five cases in each group.The control group was treated with conventional anal-gesics combined with TAPB for PCIA,and the observation group was treated with nalbuphine combined with TAPB for PCIA.The differences of pain perception[visual analogue pain score(VAS)]and sedation[Ramsay sedation score]between 2 h(T_(0)),24 h(T_(1))and 48 h(T_(2))were evaluated.The dosage of analgesic drugs,the frequency of self-controlled analgesia and the incidence of ad-verse reactions were analyzed in the two groups.Results:When the VAS and Ramsay sedation scores were lower than T_(0)in both groups of patients at T_(1)and T_(2),and when the VAS and Ramsay sedation scores were lower than T_(1)in both groups at T_(2),the differ-ence was statistically significant(P<0.05);VAS scores in the observation group were lower than those in the control group at T_(0),T_(1)and T_(2),and Ramsay sedation scores were higher than those in the control group,with statistical significance(P<0.05);The dosage of postoperative analgesia and the number of self-controlled analgesia in the observation group were lower than those in the con-trol group,the difference was statistically significant(P<0.001);The incidence of adverse reactions in observation group was lower than that in control group,and the difference was statistically significant(P=0.041).Conclusion:Nalbuphine combined with TAPB has a positive application effect in postoperative analgesia of uterine fibroids,which can effectively improve analgesia and seda-tion,reduce patients'dependence on analgesic drugs,and reduce the incidence of adverse reactions.