Pugh G C, Drummond G B
Department of Anaesthetics, Royal Infirmary of Edinburgh.
Br J Anaesth. 1987 Nov;59(11):1356-63. doi: 10.1093/bja/59.11.1356.
Six male patients were studied on the morning following upper abdominal surgery for highly selective vagotomy. Nalbuphine hydrochloride was infused i.v. at different rates that increased progressively in each hour over a 4-h period. In the last 15 min of each hour, the plasma nalbuphine concentrations were almost steady (73-68, 71-82, 116-113 and 201-208 ng ml-1). Patients and an observer made hourly assessments of pain and sedation. Although the changes in the pain and sedation scores were not significant, the patients' mean pain scores increased when the mean plasma nalbuphine concentrations were greater (greater than 82 ng ml-1), which suggested that nalbuphine analgesia had been reversed. Nalbuphine caused sedation and possibly induced amnesia which could invalidate retrospective assessment, since the patients' assessment of analgesic efficacy at the end of the study was good. No cardiovascular depression or significant decrease in the ventilatory rate was recorded.
对6名接受高选择性迷走神经切断术的上腹部手术后次日上午的男性患者进行了研究。盐酸纳布啡以不同速率静脉输注，在4小时内每小时逐渐增加。在每个小时的最后15分钟，血浆纳布啡浓度几乎稳定（73 - 68、71 - 82、116 - 113和201 - 208 ng/ml）。患者和一名观察者每小时对疼痛和镇静程度进行评估。尽管疼痛和镇静评分的变化不显著，但当平均血浆纳布啡浓度较高（大于82 ng/ml）时患者的平均疼痛评分增加，这表明纳布啡的镇痛作用已被逆转。纳布啡引起镇静并可能导致失忆，这可能使回顾性评估无效，因为患者在研究结束时对镇痛效果的评估良好。未记录到心血管抑制或通气率显著下降。
