小剂量纳美芬预先给药对结直肠癌手术患者术后疼痛的影响

目的观察小剂量纳美芬预先给药对结直肠癌手术患者术后疼痛的影响。方法选取择期行开腹结直肠癌手术患者60例,ASAⅠ或Ⅱ级,随机均分为纳美芬组和对照组。纳美芬组麻醉诱导前10 min静脉注射纳美芬0.2μg·kg-1,对照组给予等容量氯化钠注射液。2组均采用全身静脉麻醉,术后给予患者自控静脉镇痛。记录拔管即刻和拔管后6、12、18、24、48 h的疼痛视觉模拟量表(VAS)评分及术后24 h内镇痛泵按压次数及曲马多追加量。观察并记录手术时间、呼吸恢复时间、拔管时间、排气时间等,以及术后不良反应发生情况。结果纳美芬组和对照组各完成28例,拔管即刻和拔管后6、12、18 h纳美芬组VAS评分均低于对照组(P <0.05),纳美芬组术后24 h镇痛泵按压次数及曲马多追加量均少于对照组(P <0.05)。2组手术时间、麻醉时间无显著差异(P> 0.05),纳美芬组呼吸恢复时间、拔管时间、排气时间短于对照组(P <0.05)。纳美芬组术后恶心呕吐发生率为25%(7/28)低于对照组(54%,15/28,P <0.05),头晕发生率组间比较无显著差异(P> 0.05)。结论小剂量纳美芬预先给药能减轻结直肠癌手术患者术后疼痛,缩短呼吸恢复、拔管和排气时间,且较安全。

Effects of pre-injection of low dose nalmefene on postoperative pain of patients undergoing colorectal cancer surgery

AIM To observe the effects of pre-injection of low dose nalmefene on postoperative pain of patients undergoing colorectal cancer surgery. METHODS Sixty patients, scheduled for elective open colorectal cancer surgery, ASA physical status Ⅰ or Ⅱ, were randomly divided into nalmafene group(group N)and control group(group C). Group N was given intravenous infusion of nalmefene 0.2 μ g·kg-1 10 minutes before induction. Group C was treated with the same dose of chloride sodium injection. Total intravenous anesthesia was used in both groups, and patient-controlled intravenous analgesia(PCIA) was given after surgery. The visual analogue scale(VAS)score of pain at 6, 12, 18, 24 and 48 h after extubation were recorded. The press times of PCIA during 24 h after the surgery and postoperative additional dose of tramadol were recorded. Operation time,postoperative respiratory recovery time,extubation time,the first anus exhausting time and adverse reactions were observed and recorded. RESULTS The group N and group C completed 28 cases respectively,and the VAS score was lower in the group N than that in the group C at 6, 12, 18 h after extubation(P < 0.05). The press times of PCIA during 24 h after the surgery and postoperative additional dose of tramadol in the group N were less than those in the group C(P < 0.05). There was no significant difference in operation time and anesthesia time between the two groups(P > 0.05). Postoperative respiratory recovery time,extubation time and the first anus exhausting time were shorter in the group N than those in the group C(P < 0.05). The incidence of postoperative nausea and vomiting in the group N was 25%(7/28) and it was lower than that in the control C(54%, 15/28, P < 0.05). However, the incidence of dizziness showed no significant difference between the two groups(P > 0.05). CONCLUSION Preinjection of low dose nalmefene can effectively relieve postoperative pain and shorten respiratory recovery time,extubation time and the first anus exhausting time in patients undergoing colorectal cancer surgery,and it is safe.