纳布啡联合瑞芬太尼静脉自控对产妇术后镇痛效果及血清PRL、Cor水平的影响

目的探讨纳布啡联合瑞芬太尼静脉自控对产妇术后镇痛效果及血清PRL、Cor水平的影响。方法选取2017年5月至2019年2月于江阴市第五人民医院手术室进行腰硬联合麻醉剖宫产的120例初产妇为研究对象。随机将其分为观察组和对照组,每组60例初产妇。观察组初产妇采用纳布啡联合瑞芬太尼静脉自控镇痛,对照组初产妇采用瑞芬太尼静脉自控镇痛,观察两组初产妇的术后镇痛、镇静效果和PRL、Cor水平之间的差异。结果安静状态下,两组初产妇1、3、9、12、24、36小时的疼痛量表评分之间的差异均无统计学意义(均P>0.05);咳嗽状态下,在6小时和9小时,观察组初产妇的疼痛量表评分显著低于对照组初产妇;两组初产妇术后1、3、9、12、24、36小时的Ramsay评分之间的差异均无统计学意义(均P>0.05);两组初产妇的血清PRL、Cor水平均有显著改善,且观察组初产妇的血清PRL水平高于对照组初产妇,Cor水平低于对照组初产妇。结论纳布啡联合瑞芬太尼静脉自控产妇,血清PRL水平显著升高,Cor水平显著降低,术后镇痛效果显著,建议在临床推广应用。

Effect of nabufen combined with intravenous controlled remifentanil on the postoperative analgesia and serum prolactin and cortisol levels in puerperae

Objective To explore the effect of nabufen combined with intravenous controlled remifentanil on the postoperative analgesia and serum prolactin(PRL)and cortisol(Cor)levels in puerperae.Methods 120 puerperae undergoing caesarean section under combined spinal and epidural anesthesia in Fifth People′s Hospital of Jiangyin City from May 2017 to February 2019 were selected and randomly divided into observation group and control group,60 cases in each group.The observation group was given intravenous controlled analgesia with nabufen and remifentanil,while the control group was given intravenous controlled analgesia with remifentanil only.The effects of postoperative analgesia,sedation and the difference in labor analgesia parameters,delivery conditions and PRL and Cor levels were observed in the two groups.Results In the quiet state,there was no significant difference between the two groups in pain scale scores of 1,3,9,12,24 and 36 hours(all P>0.05).In the cough state,the pain scale scores of the observation group were significantly lower than those of the control group at 6 and 9 hours.There was no significant difference in the Ramsay scores between the two groups at 1,3,9,12,24 and 36 hours after operation(all P>0.05).The serum PRL and Cor levels in the two groups were significantly improved,and the serum PRL levels in the observation group were significantly higher and Cor level was lower than those of control group accordingly.Conclusions There is a significant increase in the serum PRL level and decrease in the Cor levels of puerperae after treatment of nabufen combined with intravenous controlled remifentanil with significant analgesic effect,which should be recommended in clinic.