预先注射纳布啡对内镜下食管静脉曲张套扎术后疼痛的影响  

Analgesic effect of pretreatment of nalbuphine in endoscopic analgesia esophageal varices ligation

作　　者：邢娜[1] 渠明翠 张建文[1] 李平乐[1] 周文娟[1] 张卫[1] XING Na;QU Mingcui;ZHANG Jianwen;LI Pingle;ZHOU Wenjuan;ZHANG Wei(Department of Anesthesiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院麻醉科

出　　处：《临床麻醉学杂志》2019年第10期999-1001,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察静脉预先注射纳布啡对内镜下食管静脉曲张套扎治疗术后镇痛的临床效果。方法选择拟行内镜下食管静脉曲张套扎治疗的患者60例,男35例,女25例,年龄30~65岁,ASAⅡ或Ⅲ级,采用随机数字表法分为两组:纳布啡组(N组)和曲马多组(Q组),每组30例。手术开始前,N组静脉注射纳布啡0.1 mg/kg,Q组静脉注射曲马多1 mg/kg,记录两组离开PACU、胃镜检查结束后24、48 h的VAS疼痛评分;记录两组拔管时间和离开PACU时间;记录两组术后恶心呕吐、头晕、腹痛腹胀等不良反应的发生情况。结果离开PACU时N组VAS疼痛评分明显低于Q组(P<0.05),胃镜检查后24、48 h两组VAS疼痛评分差异无统计学意义。两组拔管时间、离开PACU时间差异无统计学意义。N组恶心呕吐发生率明显低于Q组[1例(3%)vs 6例(20%),P<0.05]。Q组有1例发生头晕、腹痛腹胀,N组有1例发生头晕。结论静脉预先注射纳布啡可有效缓解内镜下食管静脉曲张套扎治疗患者术后疼痛,且不良反应发生率低。Objective To observe the postoperative analgesic effect of pretreatment with nalbuphine in endoscopic esophageal varix ligation. Methods Sixty patients who underwent esophageal varices ligation, 35 males and 25 females, aged 30-65 years, falling into ASA physical status Ⅱ or Ⅲ, were randomly divided in 2 groups: group N and group Q, 30 cases in each group. Patients in group N were injected with nalbuphine 0.1 mg/kg, and patients in group Q were injected with tramadol 1 mg/kg. The pain of patients was assessed by VAS scores at the time for leaving post anesthesia care unit, 24 and 48 h after gastroscopy finished. Time of extubation and time for leaving post anesthesia care unit were recorded. The incidence of postoperative nausea and vomiting, dizziness, abdominal pain and distension were recorded. Results The VAS scores in group N were lower than thoses in group Q at the time for leaving post anesthesia care unit(P < 0.05). There was no statistically significant difference in VAS scores 24 and 48 h after gastroscopy finished. There was no statistical difference in extubation time and time for leaving post anesthesia care unit between the two groups. The occurrence of postoperative nausea and vomiting in group N was significantly lower than that in group Q [1 cases(3%)vs 6 cases(20%), P < 0.05]. There was no statistical difference of the other adverse reactions between the two groups. Conclusion Pretretment with nalbuphine in esophageal varix ligation can alleviate the postoperative pain, it also can reduce the occurrence of postoperative nausea and vomiting.

关 键 词：纳布啡 曲马多 食管静脉曲张套扎 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]