Chen Peng, Wang Honghua, Liu Dajin, Jing Xu
Department of Anaesthesiology, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, Suzhou, China.
Department of Anaesthesiology, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, China.
J Coll Physicians Surg Pak. 2025 Apr;35(4):403-407. doi: 10.29271/jcpsp.2025.04.403.
To investigate the optimal dosage of nalbuphine preemptive analgesia on pain after laparoscopic cholecystectomy.
A double-blind, randomised study. Place and Duration of the Study: Department of Anaesthesiology, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an Second Hospital, Jiangsu Province, China, from 2020 to 2023.
This study enrolled 240 patients requiring elective laparoscopic cholecystectomy. Patients were randomly allocated into four groups receiving placebo (Group NS) or nalbuphine 0.1 mg/kg (Group N1) or 0.2 mg/kg (Group N2) or 0.3 mg/kg (Group N3) intravenously 15 minutes before surgery. The postoperative visual analogue scale (VAS) score, and the rescue analgesic requirement within 72 hours after surgery were evaluated. One-way analysis of variance and a non-parametric Kruskal-Wallis test were used to compare differences between the groups.
The VAS scores at rest and on movement were significantly lower in the N2 and N3 groups compared to the placebo group at 4, 12, 24, and 48 hours after surgery (p <0.05). Moreover, the VAS scores of the N2 group were significantly lower than N1 and N3 groups. The first rescue analgesia time was significantly longer (p <0.05), and the rescue analgesic requirements were considerably reduced in the N2 group than in the placebo group (p <0.05).
Nalbuphine preemptive analgesia provided effective analgesia in patients undergoing laparoscopic cholecystectomy. The results showed that the optimal dose was 0.2 mg/kg for nalbuphine preemptive analgesia in laparoscopic cholecystectomy.
Nalbuphine, Preemptive analgesia, Laparoscopic cholecystectomy, Postoperative pain, Rescue analgesia, VAS score.
探讨纳布啡超前镇痛用于腹腔镜胆囊切除术后镇痛的最佳剂量。
一项双盲随机研究。研究地点和时间：中国江苏省淮安市徐州医科大学附属淮安医院（淮安市第二医院）麻醉科，2020年至2023年。
本研究纳入240例择期行腹腔镜胆囊切除术的患者。患者被随机分为四组，分别在手术前15分钟静脉注射安慰剂（生理盐水组）或0.1mg/kg纳布啡（N1组）或0.2mg/kg纳布啡（N2组）或0.3mg/kg纳布啡（N3组）。评估术后视觉模拟评分（VAS）及术后72小时内的补救性镇痛需求。采用单因素方差分析和非参数Kruskal-Wallis检验比较组间差异。
术后4、12、24和48小时，N2组和N3组静息及活动时的VAS评分均显著低于安慰剂组（p<0.05）。此外，N2组的VAS评分显著低于N1组和N3组。N2组首次补救性镇痛时间显著延长（p<0.05），且补救性镇痛需求较安慰剂组显著减少（p<0.05）。
纳布啡超前镇痛可为腹腔镜胆囊切除术患者提供有效的镇痛效果。结果表明，腹腔镜胆囊切除术中纳布啡超前镇痛的最佳剂量为0.2mg/kg。
纳布啡；超前镇痛；腹腔镜胆囊切除术；术后疼痛；补救性镇痛；VAS评分
