Gong Yong, Zhang Yang, Tao Shoujun
Department of Anesthesiology, The First People's Hospital of Jingzhou, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei 434020, P.R. China.
Department of Anesthesiology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China.
Exp Ther Med. 2018 Jan;15(1):859-863. doi: 10.3892/etm.2017.5452. Epub 2017 Nov 6.
The present study evaluated the use of nalbuphine for analgesia after fraction reduction surgery. Eighty lower limb fracture patients needing open reduction and internal fixation were selected in the First People's Hospital of Jingzhou from January 2015 to December 2015. Patients were randomly divided into observation and control groups (with 40 cases in each). After surgery, the patients in the observation group were treated with nalbuphine (2 mg/kg) for patient-controlled intravenous analgesia (PCIA), while sufentanil (2.5 µg/kg) was used for patients in the control group. The analgesia treatment lasted for 48 h after surgery. Changes in inflammatory factors and catecholamine hormones during the observation period were determined and compared between the groups. Pain, sedation scores and the number of times the analgesia pump was used were recorded at different time-points. Additionally, the life and sleep qualities and any adverse reactions were also recorded. Our results showed that after the operation, the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), high-sensitivity CRP (hs-CRP) cortisol, adrenaline epinephrine (AD) and norepinephrine (NE) were significantly lower in the observation group than in the control group (P<0.05). Pain and sedation scores of patients in the observation group were better than those in the control group at all time-points after operation (P<0.05). Life and sleep qualities of patients in the observation group were also better than those in the control group (P<0.05). Finally, the rates of nausea, vomiting, dizziness, lethargy, urinary retention, skin itch and constipation were significantly lower in the observation group than in control group (P<0.05). Based on our findings, the application of nalbuphine for analgesia in patients with fracture surgeries can reduce the levels of inflammatory cytokines, improve the analgesic effect, bring beneficial sedative effects and reduce the occurrence of adverse reactions.
本研究评估了纳布啡在骨折复位手术后镇痛中的应用。2015年1月至2015年12月，在荆州市第一人民医院选取80例需要切开复位内固定的下肢骨折患者。患者被随机分为观察组和对照组（每组40例）。术后，观察组患者采用纳布啡（2mg/kg）进行患者自控静脉镇痛（PCIA），而对照组患者使用舒芬太尼（2.5μg/kg）。镇痛治疗在术后持续48小时。测定并比较两组观察期内炎症因子和儿茶酚胺激素的变化。记录不同时间点的疼痛、镇静评分以及镇痛泵的使用次数。此外，还记录了生活和睡眠质量以及任何不良反应。我们的结果显示，术后观察组白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、白细胞介素-1（IL-1）、高敏C反应蛋白（hs-CRP）、皮质醇、肾上腺素（AD）和去甲肾上腺素（NE）水平显著低于对照组（P<0.05）。术后所有时间点，观察组患者的疼痛和镇静评分均优于对照组（P<0.05）。观察组患者的生活和睡眠质量也优于对照组（P<0.05）。最后，观察组恶心、呕吐、头晕、嗜睡、尿潴留、皮肤瘙痒和便秘的发生率显著低于对照组（P<0.05）。基于我们的研究结果，纳布啡应用于骨折手术患者的镇痛可降低炎症细胞因子水平，提高镇痛效果，带来有益的镇静作用并减少不良反应的发生。
