Mao Yu, Cao Yuanyuan, Mei Bin, Chen Lijian, Liu Xuesheng, Zhang Zhi, Gu Erwei
Key Laboratory of Brain Function and Disease of Chinese Academy of Science, Department of Biophysics and Neurobiology, University of Science and Technology of China, Hefei, Anhui 230027, China.
Department of Anesthesiology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230031, China.
Pain Res Manag. 2018 Jan 28;2018:3637013. doi: 10.1155/2018/3637013. eCollection 2018.
To assess different doses of nalbuphine with flurbiprofen compared to sufentanil with flurbiprofen in multimodal analgesia efficacy for elderly patients undergoing gastrointestinal surgery with a transverse abdominis plane block (TAPB).
158 elderly patients scheduling for elective open gastrointestinal surgery under general anesthesia and TAPB were randomly assigned to four groups according to different doses of nalbuphine with flurbiprofen in postoperative intravenous analgesia (PCIA). Postoperative pain intensity, effective pressing numbers of PCIA, and adverse effects were recorded at 6, 12, 24, and 48 hours after surgery.
Postoperative pain intensity, effective pressing numbers, and the incidence of postoperative nausea and vomiting (PONV) were similar among the four groups after surgery, while the severity of PONV was decreased in Group L compared with Group S at 6, 12, and 48 h after surgery. No individual experienced pruritus, respiratory depression, or hypotension.
Low dose of nalbuphine (15 g·kg·ml) combined with flurbiprofen is superior for elderly patients undergoing elective open gastrointestinal surgery with TAPB in terms of the efficient postoperative analgesia and decreased severity of PONV. This trial is registered with NCT02984865.
评估在老年患者行横腹直肌平面阻滞（TAPB）的胃肠道手术中，不同剂量纳布啡联合氟比洛芬与舒芬太尼联合氟比洛芬在多模式镇痛效果上的差异。
158例计划在全身麻醉和TAPB下行择期开放性胃肠道手术的老年患者，根据术后静脉镇痛（PCIA）中纳布啡联合氟比洛芬的不同剂量随机分为四组。记录术后6、12、24和48小时的术后疼痛强度、PCIA有效按压次数及不良反应。
四组术后疼痛强度、有效按压次数及术后恶心呕吐（PONV）发生率相似，但术后6、12和48小时，L组PONV严重程度低于S组。无个体出现瘙痒、呼吸抑制或低血压。
低剂量纳布啡（15μg·kg·ml）联合氟比洛芬在老年患者行择期开放性胃肠道手术并采用TAPB时，在术后有效镇痛及降低PONV严重程度方面更具优势。本试验已在NCT02984865注册。
