纳布啡联合舒芬太尼在肝胆外科腹腔镜术后的镇痛效果

目的探讨纳布啡联合舒芬太尼用于肝胆外科腹腔镜术后患者自控镇痛(PCA)的临床疗效。方法选取2018年1月-2020年1月该院收治的120例腹腔镜肝胆外科手术患者作为研究对象,随机分为舒芬太尼组(S组)、纳布啡组(N组)和纳布啡联合舒芬太尼组(N+S组),每组各40例。S组术后镇痛使用舒芬太尼,N组术后镇痛使用纳布啡,N+S组术后镇痛使用纳布啡联合舒芬太尼,记录3组患者术后不同时间段心率(HR)、平均动脉压(MAP)、视觉模拟评分(VAS)、术后PCA按压次数和不良反应发生情况。结果 N+S组在术后10 min (T_3)、30 min (T_4)和60 min (T_5)的MAP及HR均明显低于S组,且在T_4及T_5时点,N+S组较N组HR及MAP明显降低,两组比较,差异均有统计学意义(P 0.05)。N+S组在术后8 h (T_7)、12 h (T_8)和24 h (T_9)的VAS评分明显低于S组,N+S组术后PCA按压次数明显少于S组,两组比较,差异均有统计学意义(P 0.05)。N+S组的不良反应总发生率明显低于N组及S组,差异有统计学意义(P 0.05)。结论纳布啡与舒芬太尼联合应用于肝胆外科腹腔镜术后镇痛效果良好,且用药安全性高,值得临床推广使用。

Clinical effect of Nalbuphine combined with Sufentanil after laparoscopy in hepatobiliary surgery

Objective To investigate the clinical efficacy of Nalbuphine combined with Sufentanil for patient-controlled analgesia (PCA) after laparoscopic surgery in hepatobiliary surgery.Methods 120 patients underwent laparoscopic hepatobiliary surgery from January 2018 to January 2020 were selected as the research objects. They were divided into S group, N group and N + S group by random method, with 40 cases in each group. Patients in group S were treated with Sufentanil for postoperative analgesia, patients in group N were treated with Nalbuphine for postoperative analgesia, and patients in group N + S were treated with Nalbuphine combined with Sufentanil for postoperative analgesia. The heart rate (HR), mean arterial pressure (MAP), and visual analogue scales (VAS) of the three groups were recorded. The number of PCA compressions and the occurrence of adverse reactions in the three groups were recorded.Results The MAP and HR of the N + S group were significantly lower than those of the S group at 10 min (T₃), 30 min (T₄), and 60 min (T₄) after the operation, and at T₄ and T₅, the HR and MAP of the N + S group were significantly lower than those of the N group, the differences were statistically significant (P < 0.05). The VAS scores of patients in the N + S group at 8 h (T₇), 12 h (T₈), and 24 h (T₉) after surgery were significantly lower than those of the S group. The number of PCA compressions in the N + S group was significantly less than that of the S group, and the differences were statistically significant (P < 0.05). The number of adverse reactions in the N + S group was significantly lower than that of the N and S groups, and the difference was statistically significant (P < 0.05).Conclusion The combined application of Nalbuphine and Sufentanil in laparoscopic postoperative analgesia in hepatobiliary surgery can achieve good analgesic effects and high drug safety, and it is worthy of popularization.