Crul J F, Smets M J, van Egmond J
Medical Faculty University of Nijmegen, The Netherlands.
Acta Anaesthesiol Belg. 1990;41(3):261-7.
In a prospective double blind study the efficacy and safety of nalbuphine as an analgesic in balanced anesthesia has been compared to fentanyl. In 63 patients, ASA class I-III, major gynecological or urological surgical procedures were performed under balanced anesthesia. Analgesia could be satisfactory maintained in all cases, but in cases of nalbuphine more hypnotics were necessary to keep the patients unconscious. The ratio of fentanyl and nalbuphine consumption was 1:200 (by weight). The nalbuphine cases can be distinguished by: more stable but higher arterial pressures and absence of arrythmia; lower incidence of nausea and vomiting in the postoperative period; less respiratory depression at the end of anesthesia, not needing antagonists, as compared to 11 patients needing antagonization in the fentanyl group; and a larger incidence of minor local allergic reactions at the injection site. Awareness was not observed in any patient of either group. Although nalbuphine has a weaker analgesic and hypnotic effect, it is perfectly possible to provide balanced anesthesia in combination with a hypnotic and a muscle relaxant. Advantages are the absence of respiratory depression as well as nausea and vomiting in the postoperative period.
在一项前瞻性双盲研究中，已将纳布啡作为平衡麻醉中镇痛药的有效性和安全性与芬太尼进行了比较。63例ASA I - III级患者在平衡麻醉下接受了大型妇科或泌尿外科手术。所有病例的镇痛效果均能令人满意地维持，但使用纳布啡的病例需要更多的催眠药来使患者保持无意识状态。芬太尼与纳布啡的使用量之比为1:200（按重量计）。使用纳布啡的病例具有以下特点：动脉压更稳定但更高且无心律失常；术后恶心和呕吐的发生率较低；与芬太尼组11例需要拮抗的患者相比，麻醉结束时呼吸抑制较轻，无需拮抗剂；注射部位轻微局部过敏反应的发生率较高。两组患者均未观察到术中知晓情况。虽然纳布啡的镇痛和催眠作用较弱，但与催眠药和肌肉松弛剂联合使用完全有可能提供平衡麻醉。其优点是术后无呼吸抑制以及恶心和呕吐。
