纳布啡在剖宫产术后静脉自控镇痛患者中的镇痛镇静效果分析

目的:探讨纳布啡在剖宫产术后静脉自控镇痛患者中的镇痛镇静效果。方法:选择2019年6月至2020年3月于萍乡市安源区妇幼保健院产科行剖宫产手术的401例产妇,采用随机数表法分为布托啡诺组(n=200)和纳布啡组(n=201),两组术后均行静脉自控镇痛。比较两组不同时点疼痛视觉模拟量表(VAS)评分包括术后2 h(T₁)、术后6 h(T₂)、术后12 h(T₃)、术后24 h(T4)VAS评分]、Ramsay镇静评分包括T₁、T₂、T₃、T4时Ramsay镇静评分]、泌乳始动时间以及不良反应发生情况包括恶心呕吐、烦躁焦虑、嗜睡、头晕头痛]。结果:纳布啡组T₁~T4时VAS评分低于布托啡诺组,差异有统计学意义(P<0.05);两组T₁~T4时Ramsay镇静评分比较,差异无统计学意义(P>0.05);两组泌乳始动时间比较,差异无统计学意义(P>0.05);纳布啡组不良反应发生率较布托啡诺组低,差异有统计学意义(P<0.05)。结论:纳布啡在剖宫产术后静脉自控镇痛患者中的镇痛效果较好,镇静效果与布托啡诺相当,对产妇泌乳始动时间影响较小,且安全性较好。

Analysis of the Analgesic and Sedative Effects of Nalbuphine in Patients with Intravenous Analgesia after Cesarean Section

Objective:To investigate the analgesic and sedative effects of nalbuphine in patients with intravenously controlled analgesia after cesarean section.Methods:401 puerperas who performed cesarean section in the Department of Obstetrics in Anyuan District Maternal and Child Health Hospital from June 2019 to March 2020 were selected.They were divided into a butorphanol group(n=200)and a nalbuphine group(n=201)according to random number table method.All patients of two groups received intravenous analgesia after operation.The control group was given butorphanol and the observation group was given nalbuphine.Compared the visual analogue scale(VAS)scores of pain between two groups at different time pointsincluding 2 h(T₁)postoperatively,6 h(T₂)postoperatively,12 h(T₃)postoperatively,24 h(T₄)postoperatively VAS score],score of Ramsay sedationincluding Ramsay sedation score at T₁,T₂,T₃,T₄],the time of onset of lactation and the occurrence of adverse reactionsincluding nausea and vomiting,irritability and anxiety,drowsiness,dizziness and headache].Results:The VAS scores of the nalbuphine group at T₁-T₄ were higher than those of the butorphanol group,there was a statistical significant difference(P<0.05);compared the Ramsay sedation score at T₁-T₄ of both groups,there was no statistical significant difference(P>0.05);compared lactation onset time between the two groups,there was no statistical significant difference(P>0.05);the incidence of adverse reactions of the nalbuphine group was lower than the butorphanol group,there was a statistical significant difference(P<0.05).Conclusion:The analgesic effect of nalbuphine was better than that of butorphanol in patients with intravenously controlled analgesia after cesarean section,which has less effect on the onset time of lactation and has high safety.