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纳布啡和右美托咪定预防内镜鼻窦手术中疼痛的效果。

Effect of Preventive Analgesia with Nalbuphine and Dexmedetomidine in Endoscopic Sinus Surgery.

机构信息

Department of Anesthesiology, Department of Pain, The Affiliated Huaian Hospital of Xuzhou Medical University, Huaian Second People's Hospital, Huaian, Jiangsu, China.

Department of General Surgery, The Affiliated Huaian Hospital of Xuzhou Medical University, Huaian Second People's Hospital, Huaian, Jiangsu, China.

出版信息

Pain Res Manag. 2022 May 31;2022:2344733. doi: 10.1155/2022/2344733. eCollection 2022.

Abstract

BACKGROUND

The study was to assess the efficacy and safety of nalbuphine combined with dexmedetomidine for preventive analgesia in endoscopic sinus surgery.

METHODS

110 patients with deviation of the nasal septum were randomized into the nalbuphine group (group N), dexmedetomidine combined with nalbuphine group (group DN), and saline group (group C). Fifteen minutes before the induction of anesthesia, patients in group N were injected nalbuphine 0.2 mg/kg intravenously; patients in group DN received intravenous infusion of dexmedetomidine 0.5 g/kg and injection of nalbuphine 0.2 mg/kg; patients in group C received 0.9% saline. Mean arterial pressure (MAP), heart rate (HR), numerical rating scale (NRS) scores, quality of recovery-40 (QoR-40) scores, the need for remedial analgesia, the consumption of remifentanil and propofol, and the incidence of adverse reactions were recorded.

RESULTS

MAP, HR, and NRS scores of the DN group were significantly lower and the QoR-40 scores were higher than those of groups N and C ( < 0.001). The need for remedial analgesia, the consumption of remifentanil and propofol, and the incidence of nausea in the DN group were the lowest among the three groups ( < 0.001).

CONCLUSION

Preventive analgesia with nalbuphine and dexmedetomidine in endoscopic sinus surgery can not only maintain hemodynamic stability but also reduce intraoperative anesthetic dosage, postoperative pain, and improve the quality of postoperative recovery without affecting the revival and extubation time.

摘要

背景

本研究旨在评估纳布啡联合右美托咪定用于鼻内镜鼻窦手术预防性镇痛的疗效和安全性。

方法

将 110 例鼻中隔偏曲患者随机分为纳布啡组(N 组)、右美托咪定复合纳布啡组(DN 组)和生理盐水组(C 组)。麻醉诱导前 15min,N 组静脉注射纳布啡 0.2mg/kg;DN 组静脉泵注右美托咪定 0.5μg/kg,同时静脉注射纳布啡 0.2mg/kg;C 组静脉输注生理盐水。记录平均动脉压(MAP)、心率(HR)、数字评分量表(NRS)评分、恢复质量 40 项量表(QoR-40)评分、补救性镇痛需求、瑞芬太尼和丙泊酚用量以及不良反应发生率。

结果

DN 组 MAP、HR 和 NRS 评分均明显低于 N 组和 C 组,QoR-40 评分明显高于 N 组和 C 组(<0.001)。DN 组补救性镇痛需求、瑞芬太尼和丙泊酚用量及恶心发生率均明显低于 N 组和 C 组(<0.001)。

结论

鼻内镜鼻窦手术中采用纳布啡联合右美托咪定预防性镇痛,不仅能维持血流动力学稳定,而且能减少术中麻醉药物用量、减轻术后疼痛、提高术后恢复质量,不影响苏醒和拔管时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3122/9173995/66de08bc7e4a/PRM2022-2344733.001.jpg

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