Akshat Shiv, Ramachandran Rashmi, Rewari Vimi, Trikha Anjan, Sinha Renu
Department of Anaesthesiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
Pain Res Treat. 2014;2014:727952. doi: 10.1155/2014/727952. Epub 2014 Apr 14.
Introduction. Pain is the commonest morbidity after open surgical procedures. The most effective treatment of postoperative pain is opioid therapy. Morphine, the commonly used opioid, is associated with many side effects including respiratory depression, sedation, postoperative nausea vomiting, and pruritus. Nalbuphine, on the other hand, is known to cause less respiratory depression. Thus this study was undertaken to compare the intraoperative and postoperative analgesic efficacy and side effect profile of the two drugs. Methodology. 60 patients undergoing open gynaecological surgery were randomized to receive either morphine (Group M) or nalbuphine (Group N) in the intraoperative and postoperative period. Intraoperative analgesic efficacy (measured by need for rescue analgesics), postoperative pain by visual analogue scale, and side effects like postoperative nausea, vomiting, sedation, respiratory depression, and pruritus were compared in both groups. Intraoperative and postoperative heart rate and blood pressure were also compared between the groups. Results. Need for intraoperative analgesia was significantly more in Group N (P = 0.023). Postoperative VAS scores were significantly different between the groups at various time points; however, none of the patients required any rescue analgesia. The incidence of various side effects was not significantly different between the groups. The haemodynamic profile of patients was comparable between the groups in both intraoperative and postoperative period. Conclusion. Nalbuphine provides less effective intraoperative analgesia than morphine in patients undergoing open gynaecological surgery under general anaesthesia. Both drugs, however, provided similar postoperative analgesia and had similar haemodynamic and side effect profile.
引言。疼痛是开放性外科手术后最常见的病症。术后疼痛最有效的治疗方法是阿片类药物治疗。常用的阿片类药物吗啡会引发许多副作用，包括呼吸抑制、镇静、术后恶心呕吐和瘙痒。另一方面，纳布啡已知会引起较少的呼吸抑制。因此，本研究旨在比较这两种药物在术中和术后的镇痛效果及副作用情况。方法。60例行开放性妇科手术的患者在术中和术后被随机分为两组，分别接受吗啡（M组）或纳布啡（N组）治疗。比较两组的术中镇痛效果（通过急救镇痛药的需求来衡量）、视觉模拟量表评估的术后疼痛以及术后恶心、呕吐、镇静、呼吸抑制和瘙痒等副作用。同时比较两组术中和术后的心率及血压。结果。N组术中镇痛需求显著更多（P = 0.023）。两组在不同时间点的术后视觉模拟量表评分有显著差异；然而，没有患者需要任何急救镇痛。两组各种副作用的发生率无显著差异。两组患者在术中和术后的血流动力学情况相当。结论。在全身麻醉下进行开放性妇科手术的患者中，纳布啡的术中镇痛效果不如吗啡。然而，两种药物的术后镇痛效果相似，血流动力学和副作用情况也相似。
