舒芬太尼复合纳布啡用于剖宫产术后自控静脉镇痛的效果  

Effect of sufentanil combined with nalbuphine on patient-controlled intravenous analgesia after cesarean section

作　　者：王楠 董铁立[1] 付红光[1] WANG Nan;DONG Tieli;FU Hongguang.(Department of Anesthesiology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, China)

机构地区：[1]郑州大学第二附属医院麻醉科,郑州市450014

出　　处：《临床麻醉学杂志》2018年第5期449-451,共3页Journal of Clinical Anesthesiology

摘　　要：目的研究舒芬太尼复合纳布啡用于剖宫产术后患者自控静脉镇痛(PCIA)的效果。方法选择2016年1月至2017年3月于本院行剖宫产手术的初产妇150例,年龄20～35岁,体重54～89kg,ASAⅠ或Ⅱ级,随机将产妇分为三组,每组50例。舒芬太尼组(S组):舒芬太尼2μg/kg+托烷司琼10mg;纳布啡组(N组):纳布啡2mg/kg+托烷司琼10mg;舒芬太尼复合纳布啡组(SN组):舒芬太尼1μg/kg+纳布啡1mg/kg+托烷司琼10mg。记录术后1、3、6、9、12、24和36h静息和咳嗽时的疼痛VAS评分及镇静Ramsay评分;PCIA实际按压次数;恶心呕吐、呼吸抑制等不良反应的发生情况。结果三组静息时VAS评分、镇静Ramsay评分和呼吸抑制发生率差异无统计学意义;SN组咳嗽时VAS评分明显低于S组和N组(P<0.05)。SN组PCIA实际按压次数明显少于S组、N组(P<0.05)。N组和SN组恶心呕吐发生率明显低于S组(P<0.05)。结论舒芬太尼复合纳布啡用于剖宫产术后PCIA可获得满意的镇痛效果。Ojective To study the effect of sufentanil combined with nalbuphine on patient-controlled intravenous analgesia （PCIA） management after cesarean section. Methods The objects of study included 150 primiparas who underwent cesarean section in our hospital from January 2016 to March 2017, aged 20-35 years, weighing 54-89 kg, ASA physical status Ⅰ or Ⅱ. The primiparas were randomly divided into three groups, 50 in each group. Sufentanil group （group S）： sufentanil 2 μg/kg＋tropisetron 10 mg; Nalbuphine group （group N）： nalbuphine 2 mg/kg＋tropisetron 10 mg; Sufentanil combined with nalbuphine group （group SN）： sufentanil 1 μg/kg＋nalbuphine 1 mg/kg＋tropisetron 10 mg. The VAS scores, Ramsay scores and the incidence of respiratory depression of pain （rest, coughing） and Ramsay sedation scores were observed at 1, 3, 6, 9, 12, 24, 36 h after the caesarean section. Actual pressing times of PCIA were further evaluated. Adverse reactions were observed, such as nausea and vomiting, respiratory depression. Results There was no statistical difference in VAS scores, Ramsay scores and the incidence of respiratory depression of patients at rest among the three groups. However, when coughing, the VAS scores in patients of group SN were significantly lower than those of groups S and N （P〈0.05）. The incidence of nausea and vomiting in group N and group SN was significantly lower than that in group S （P〈0.05）. The actual pressing times of PCIA were significantly less in group SN than those in group S and group N （P〈0.05）. Conclusion Sufentanil combined with nalbuphine can achieve satisfactory analgesic effect on PCIA management after cesarean section.

关 键 词：舒芬太尼 纳布啡 剖宫产术 静脉自控镇痛 

分 类 号：R614[医药卫生—麻醉学]