日间腹腔镜胆囊切除术不同 μ 受体激动剂的镇痛效果。

Analgesic Effects of Different -Receptor Agonists Used in Daytime Laparoscopic Cholecystectomy.

机构信息

Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China.

Department of Pharmacy, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230036, China.

出版信息

Biomed Res Int. 2021 Dec 29;2021:2396008. doi: 10.1155/2021/2396008. eCollection 2021.

Abstract

BACKGROUND

Comparing the effect of two different -receptor agonists, nalbuphine and oxycodone, and regular morphine in patients for prophylactic analgesia of acute pain after daytime laparoscopic cholecystectomy.

METHODS

One hundred and twenty-four patients undergoing laparoscopic cholecystectomy were randomly allocated to receive nalbuphine (group N), oxycodone (group O), and morphine (group M). The three groups were all given intravenous injection (iv.) of 0.15 mg/kg injection before incision and 0.05 mg/kg injection at the end of pneumoperitoneum. The Visual Analogue Scale (VAS) scores (incision, visceral, and shoulder) and Ramsay sedation scores at 1, 2, 4, 8, 12, 16, 20, and 24 hours after surgery, the time of extubation, the incidence of postoperative adverse events, the satisfaction of pain treatment, and the duration of stay after surgery were all recorded.

RESULTS

Compared with group M, the VAS scores of visceral pain at rest decreased in group N and group O at 1-8 h after surgery ( < 0.05). The VAS scores of visceral pain at movement in group N decreased longer than those in group O ( < 0.05). Compared with that of group M, the postoperative time in Ramsay sedation score of group O increased longer than that of group N ( < 0.05). Compared with group N, patients had worse sleep quality in group O, longer length of stay in group M, and lower satisfaction in both groups.

CONCLUSION

Compared with morphine, prophylactic use of the -receptor agonists, nalbuphine and oxycodone, during laparoscopic cholecystectomy can reduce postoperative visceral pain. Furthermore, the nalbuphine group had fewer adverse reactions, better analgesia, and better satisfaction.

摘要

背景

比较两种不同μ-受体激动剂纳布啡和羟考酮与常规吗啡在日间腹腔镜胆囊切除术后急性疼痛预防中的效果。

方法

124 例腹腔镜胆囊切除术患者随机分为纳布啡组(N 组)、羟考酮组(O 组)和吗啡组(M 组)。三组均于切开前静脉注射 0.15mg/kg 注射液,气腹结束时给予 0.05mg/kg 注射液。记录术后 1、2、4、8、12、16、20、24 小时的视觉模拟评分(VAS)(切口、内脏和肩部)和 Ramsay 镇静评分、拔管时间、术后不良反应发生率、疼痛治疗满意度和术后住院时间。

结果

与 M 组相比,N 组和 O 组术后 1-8 小时静息时内脏痛 VAS 评分降低(<0.05)。N 组内脏痛运动时 VAS 评分下降时间长于 O 组(<0.05)。与 M 组相比,O 组术后 Ramsay 镇静评分时间延长(<0.05)。与 N 组相比,O 组患者睡眠质量较差,M 组患者住院时间较长,两组患者满意度较低。

结论

与吗啡相比,腹腔镜胆囊切除术前预防性使用μ-受体激动剂纳布啡和羟考酮可减轻术后内脏痛。此外,纳布啡组不良反应较少,镇痛效果较好,满意度较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4c9/8731289/8b877b048329/BMRI2021-2396008.001.jpg

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