纳布啡和吗啡用于前列腺汽化电切术后自控硬膜外镇痛的效果比较及安全性分析  

Comparisons of patient-controlled epidural analgesia effect and safety between nalbuphine and morphine for patients after transurethral vaporize electrotomy prostatae

作　　者：杨燕[1] 刘志莲[1] 张运琼 王中胜[1] 付上玉 牟秋霖 

机构地区：[1]四川省泸州市中医医院麻醉科,646000

出　　处：《检验医学与临床》2018年第1期19-22,26,共5页Laboratory Medicine and Clinic

基　　金：四川省泸州市卫生和计划生育委员会科研资助项目

摘　　要：目的对比分析盐酸纳布啡(纳布啡)和盐酸吗啡(吗啡)用于经尿道前列腺汽化电切术(TVP)后患者自控硬膜外镇痛(PCEA)的效果及安全性。方法纳入在泸州市中医医院择期行TVP患者60例,分为纳布啡组和吗啡组,每组30例,TVP后分别接受纳布啡PCEA和吗啡PCEA。分别于术后6、12、24、48、72h采用视觉模拟评分法(VAS)评价两组患者疼痛程度;观察记录两组患者的夜间睡眠状态及不良反应发生情况。结果纳布啡组患者术后6、12h的VAS分别为(1.5±0.3)分和(2.1±0.6)分,均明显低于吗啡组的(1.8±0.5)分和(2.6±0.8)分,差异均有统计学意义(P<0.05);纳布啡组患者术后当天及术后第1天夜间疼痛导致睡眠中断次数分别为(0.4±0.1)次和(0.9±0.2)次,明显少于吗啡组的(1.5±0.4)次和(2.0±0.5)次,差异均有统计学意义(P<0.05);纳布啡组患者术后未见恶心呕吐、呼吸抑制发生,总不良反应发生率(16.7%)明显低于吗啡组(43.3%),差异有统计学意义(P<0.05)。结论对于TVP术后患者,采用纳布啡PCEA效果确切,不良反应小,安全性高,且术后12h内其镇痛效果优于吗啡。Objective To analyze and compare the effect and safety of patient-controlled epidural analgesia(PCEA)with nalbuphine hydrochloride(nalbuphine)and morphine hydrochloride(morphine),which for patients after transurethral vaporize electrotomy prostatae(TVP).Methods 60 patients who undergoing TVP were randomly divided into the nalbuphine group(n=30)and the morphine group(n=30).Patients in the nalbuphine group were going to use nalbuphine PCEA after TVP,and patients in the morphine group were going to use morphine PCEA after TVP.The degree of postoperative pain were evaluated by Visual analog scales(VAS)at 6,12,24,48 and 72 hafter PCEA.Morever,the sleep state and adverse reaction of patients in the two groups were observed and recorded.Results At 6 hand 12 hafter operation,the VAS of nalbuphine group were(1.5±0.3)and(2.1±0.6),respectively,which were significantly lower than those in morphine group[(1.8±0.5)and(2.6±0.8)](P<0.05).The same day and the first day after operation,the numbers of sleep interruptions caused by night pain in the nalbuphine group were(0.4±0.1)times and(0.9±0.2)times,respectively,which were more less than that in the morphine group[(1.5±0.4)times and(2.0±0.5)times](P<0.05).The adverse reactions such as nausea and vomitting and respiratory depression had not seen in the nalbuphine group(43.3%).When compared with the morphine group,the incidence rates of total adverse reaction(16.7%)of the nalbuphine group was obviously lower(P<0.05).Conclusion Nalbuphine PCEA has a exact analgesic effect and high safety for patients after TVP.And the analgesic effect of nalbuphine is better than morphine within 12 hafter operation.

关 键 词：经尿道前列腺汽化电切术 自控硬膜外镇痛 纳布啡 吗啡 

分 类 号：R614[医药卫生—麻醉学]