Pugh G C, Drummond G B, Elton R A, Macintyre C C
Department of Anaesthetics, Royal Infirmary of Edinburgh.
Br J Anaesth. 1987 Nov;59(11):1364-74. doi: 10.1093/bja/59.11.1364.
A double-blind, sex-stratified, study compared the analgesic efficacy and side effects of nalbuphine 10 mg ml-1 (group N) and buprenorphine 0.15 mg ml-1 (group B) administered as a continuous infusion (0.2 ml kg-1/24 h), after abdominal surgery. Patients could request additional i.m. analgesic for pain. The study groups were well matched. The trial was stopped after 55 patients had been studied (nalbuphine 29, buprenorphine 26), because nine patients in the nalbuphine group had inadequate pain relief (P less than 0.01) shortly after surgery (mean 2.5 h). Analysis of the results on an "intention to treat" basis showed that the patients who received buprenorphine had significantly greater pain relief at 1, 3, 6 and 20 h after surgery. Patients who received buprenorphine were assessed by the physiotherapist to have less pain and better chest expansion. More additional analgesic was given to the patients receiving nalbuphine. In the patients receiving buprenorphine, the mean ventilatory rate was less (N = 19 b.p.m., B = 14 b.p.m.) (P less than 0.001) and the increase in PaCO2 was greater (N = 0.5 kPa, B = 1.1 kPa) (P less than 0.001), compared with the value before operation. Side effects were equal, and no serious adverse effects were observed in either group.
一项双盲、按性别分层的研究比较了腹部手术后以持续输注方式（0.2 ml/kg/24 h）给予10 mg/ml纳布啡（N组）和0.15 mg/ml丁丙诺啡（B组）的镇痛效果及副作用。患者可因疼痛要求额外的肌内注射镇痛药物。研究组间匹配良好。在研究了55例患者（纳布啡组29例，丁丙诺啡组26例）后试验停止，因为纳布啡组有9例患者在术后不久（平均2.5小时）疼痛缓解不足（P<0.01）。基于“意向性分析”的结果显示，接受丁丙诺啡的患者在术后1、3、6和20小时疼痛缓解明显更好。物理治疗师评估接受丁丙诺啡的患者疼痛较轻且胸部扩张较好。接受纳布啡的患者给予了更多的额外镇痛药物。与术前值相比，接受丁丙诺啡的患者平均通气率较低（N组=19次/分钟，B组=14次/分钟）（P<0.001），PaCO2升高幅度更大（N组=0.5 kPa，B组=1.1 kPa）（P<0.001）。两组副作用相当，且均未观察到严重不良反应。
