纳布啡在老年胃癌根治术中的应用及对患者麻醉应激反应、苏醒质量的影响

Effect of Nalbuphine in Radical Gastrectomy in Elderly Patients with Gastric Cancer and Its Influence on Anesthesia Stress Response and Recovery Quality

目的:探讨纳布啡在老年胃癌根治术中的应用及对患者麻醉应激反应和苏醒质量的影响。方法:回顾性分析2021年1月—2022年12月于莆田九十五医院进行老年胃癌根治术治疗的100例患者,根据不同的麻醉方法分组,在手术结束前30 min静脉注射氯化钠溶液的患者纳入对照组,在手术结束前30 min静脉注射纳布啡的患者纳入观察组,各50例。比较两组不同时间段的麻醉应激反应、苏醒质量及认知功能。结果:拔管时和拔管5 min时,观察组血糖、血清皮质醇和肾上腺素水平均低于对照组,差异有统计学意义(P<0.05)。两组自主呼吸恢复时间和拔管时间比较,差异无统计学意义(P>0.05);观察组苏醒时间短于对照组,Ricker镇静躁动评分低于对照组,差异有统计学意义(P<0.05)。术后1 d、3 d,观察组简易智力状态检查量表(MMSE)评分高于对照组,差异有统计学意义(P<0.05)。结论:在老年胃癌根治术中采用纳布啡的效果较显著,不仅可以有效减轻患者的麻醉应激反应,提高其苏醒质量,还可以推动其认知功能的恢复。

Objective:To investigate the effect of Nalbuphine in radical gastrectomy in elderly patients with gastric cancer and its influence on anesthesia stress response and recovery quality.Method:A retrospective analysis was performed on 100 elderly patients undergoing radical gastrectomy for gastric cancer in Putian 95 Hospital from January 2021 to December 2022.They were grouped according to different anesthesia methods,patients who received intravenous Sodium Chloride Solution at 30 min before the end of the operation were included in the control group,and those who received intravenous Nalbuphine at 30 min before the end of the operation were included in the observation group,with 50 cases in each group.The anesthetic stress response,recovery quality and cognitive function were compared between the two groups in different time periods.Result:At the time of extubation and 5 min after extubation,the levels of blood glucose,serum cortisol and adrenaline in observation group were lower than those in control group,the differences were statistically significant(P<0.05).There were no significant differences in recovery time of spontaneous respiration and extubation time between the two groups(P>0.05).The recovery time of the observation group was shorter than that of the control group,and the score of Ricker sedation and agitation was lower than that of the control group,the differences were statistically significant(P<0.05).At 1 d and 3 d after operation,the mini-mental state examination(MMSE)score of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).Conclusion:Nalbuphine is effective in radical gastrectomy in elderly patients with gastric cancer,which can not only effectively reduce the anesthetic stress response,improve the quality of recovery,but also promote the recovery of cognitive function.