氢吗啡酮复合纳布啡用于胃肠道手术后PCIA的效果  

Efficacy of hydromorphone combined with nalbuphine for PCIA after gastrointestinal surgery

作　　者：范倩倩 计根林 聂煌 陈梦媛 穆潇潇 周芳妮 杜洁娟 林菁菁 Fan Qianqian;Ji Genlin;Nie Huang;Chen Mengyuan;Mu Xiaoxiao;Zhou Fangni;Du Jiejuan;Lin Jingjing(Department of Anesthesiology and Perioperative Medicine,Xijing Hospital,Air Force Medical University,Xi′an 710032,China)

机构地区：[1]空军军医大学西京医院麻醉与围术期医学科,西安710032

出　　处：《中华麻醉学杂志》2020年第12期1471-1474,共4页Chinese Journal of Anesthesiology

摘　　要：目的评价氢吗啡酮复合纳布啡用于胃肠道手术后病人自控静脉镇痛(PCIA)的效果。方法择期行胃肠道手术病人600例,年龄18~80岁,BMI≤35 kg/m2,ASA分级Ⅰ~Ⅲ级。按随机数字表法将病人分为2组(n=300):氢吗啡酮组(H组)和舒芬太尼组(S组)。术后48 h内采用PCIA,H组配方为氢吗啡酮10 mg+纳布啡40 mg;S组配方为舒芬太尼100μg+纳布啡40 mg。2组药物均加生理盐水稀释至100 ml,背景剂量1 ml/h,单次剂量0.5 ml。记录病人术后48 h内VAS评分、镇痛有效按压次数、镇痛泵用药量、不良反应及术后恢复情况。结果2组术后48 h内VAS评分、镇痛泵用药量和镇痛泵有效按压次数比较差异无统计学意义(P>0.05)。与S组比较,H组术后48 h内头晕、恶心、呕吐发生率降低,首次下床时间缩短(P<0.05)。结论氢吗啡酮复合纳布啡用于胃肠道手术后PCIA的效果优于舒芬太尼复合纳布啡。Objective To evaluate the efficacy of hydromorphone combined with nalbuphine for patient-controlled intravenous analgesia(PCIA)after gastrointestinal surgery.Methods Six hundred patients,aged 18-80 yr,with body mass index≤35 kg/m2,of American Society of Anesthesiologists physical statusⅠtoⅢ,scheduled for elective gastrointestinal surgery,were divided into 2 groups(n=300 each)using a random number table method:hydromorphone group(group H)and sufentanil group(group S).PCIA was carried out within postoperative 48 h.In group H,PCIA solution contained hydromorphone 10 mg and nalbuphine 40 mg,diluted with normal saline to 100 ml.In group S,PCIA solution contained sufentanil 100μg and nalbuphine 40 mg,diluted with normal saline to 100 ml.The intravenous analgesia pump was programmed to deliver a background dose of 1 ml/h and a bolus dose of 0.5 ml.Visual analog scale score,effective pressing times of analgesia pump,consumption of analgesics,adverse reactions and postoperative recovery conditions were recorded within 48 h after operation.Results There was no significant difference in visual analog scale score,consumption of analgesics,and effective pressing times of analgesia pump within 48 h after operation between the two groups(P>0.05).Compared with group S,the incidence of dizziness,nausea and vomiting was significantly decreased within 48 h after operation,and first ambulation time was shortened in group H(P<0.05).Conclusion Hydromorphone combined with nalbuphine provides better efficacy than sufentanil combined with nalbuphine when used for PCIA after gastrointestinal surgery.

关 键 词：氢吗啡酮 舒芬太尼 纳布啡 镇痛 病人控制 消化系统外科手术 

分 类 号：R614[医药卫生—麻醉学]