Yang Li, Wu Jinjing, Li Tao
Department of Anesthesiology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China.
Department of Anesthesiology, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China.
Exp Ther Med. 2018 Feb;15(2):1910-1913. doi: 10.3892/etm.2017.5632. Epub 2017 Dec 14.
The aim of the present study was to investigate the analgesic effect and safety of the application of different doses of nalbuphine in patient-controlled intravenous analgesia (PCIA) for patients undergoing subtotal gastrectomy. A total of 120 patients, who underwent subtotal gastrectomy at our hospital between May, 2015 and January, 2017 under combined spinal epidural combined anesthesia, were selected. The patients received PCIA after surgery. The patients were randomly divided into four groups, including the morphine (MOP group), nalbuphine 60 mg (N60 group), nalbuphine 80 mg (N80 group) and nalbuphine 100 mg (N100 group). The first dose of PCIA treatment was 2 ml, the background dose was 2 ml/h, PCIA dose was 0.5 ml, and the lockout time was 15 min. Postoperative vital signs and adverse reactions (bleeding, fullness and aching of upper abdomen and vomiting) were recorded. The visual analogue scale (VAS) and Ramsay sedation score of patients were evaluated. The number of PCIA and analgesia-related complications during analgesia were recorded. No significant differences in general data were found among the four groups (P>0.05). The VAS score of the three nalbuphine groups was lower than that of the MOP group, but the differences were not significant. All postoperative Ramsay sedation scores of the four groups showed appropriate sedation, but no significant differences were found between the groups. Compared with the MOP group, the use of postoperative PCIA was significantly delayed and the number of PCIA was significantly smaller in the three nalbuphine groups (P<0.05). The results show that the analgesic effect and safety of the use of PCIA for patients undergoing subtotal gastrectomy were satisfactory.
本研究旨在探讨不同剂量纳布啡用于胃大部切除术患者自控静脉镇痛(PCIA)的镇痛效果及安全性。选取2015年5月至2017年1月在我院行胃大部切除术且采用腰硬联合麻醉的120例患者。患者术后接受PCIA。将患者随机分为四组,包括吗啡组(MOP组)、纳布啡60mg组(N60组)、纳布啡80mg组(N80组)和纳布啡100mg组(N100组)。PCIA治疗首剂量为2ml,背景剂量为2ml/h,PCIA剂量为0.5ml,锁定时间为15分钟。记录术后生命体征及不良反应(出血、上腹部胀满及疼痛、呕吐)。评估患者的视觉模拟评分(VAS)和Ramsay镇静评分。记录镇痛期间PCIA及镇痛相关并发症的发生次数。四组患者一般资料比较差异无统计学意义(P>0.05)。三组纳布啡组的VAS评分均低于MOP组,但差异无统计学意义。四组术后Ramsay镇静评分均显示镇静适度,但组间比较差异无统计学意义。与MOP组比较,三组纳布啡组术后PCIA使用时间明显延迟,PCIA使用次数明显减少(P<0.05)。结果表明,PCIA用于胃大部切除术患者的镇痛效果及安全性良好。