小儿尿道下裂成形术中应用纳布啡对CHEOPS疼痛评分和Ramsay镇静评分的影响  

Effects of Nalbuphine on CHEOPS Pain Score and Ramsay Sedation Score in Children with Hypospadias Surgery

作　　者：朱明[1] 章嘉平[1] Zhu Ming;Zhang Jiaping(Shanghai Children’s Medical Center,Shanghai 200127,China)

机构地区：[1]上海儿童医学中心,上海200127

出　　处：《儿科药学杂志》2021年第8期10-13,共4页Journal of Pediatric Pharmacy

摘　　要：目的:探讨纳布啡对尿道下裂成形术患儿术后镇痛及镇静作用。方法:将2017年6月至2018年12月我院收治的60例接受尿道下裂成形术患儿按照随机数字表法分为纳布啡组(N组)、曲马多组(T组)和空白对照组(C组),每组20例,在手术结束前15 min,N组静脉注射纳布啡0.2 mg/kg,T组静脉注射曲马多1.0 mg/kg,C组静脉注射生理盐水2.0 mL,比较三组患儿临床效果。结果:N组、T组CHEOPS疼痛评分在术后4 h(T1)、8 h(T2)、12 h(T3)、24 h(T4)、48 h(T5)时间点均显著低于C组(P<0.05),N组在不同时间点CHEOPS疼痛评分低于T组;N组患儿Ramsay镇静评分在T1、T2、T3、T4、T5时间点分别为(3.0±0.6)分、(2.9±0.6)分、(2.9±0.7)分、(2.7±0.6)分、(2.5±0.7)分,均显著高于T组、C组(P<0.05);T组患儿Ramsay评分在T1、T2、T3时间点分别为(2.1±0.5)分、(2.0±0.6)分、(2.0±0.6)分,均显著高于C组(P<0.05);三组患儿在不同时间点心率(HR)、血氧饱和度(SpO_(2))指标比较差异无统计学意义(P>0.05);C组患儿恶心呕吐发生率显著高于N组、T组(P<0.05),三组患儿呼吸抑制、头晕头痛、患者静脉自控镇痛(PCIA)按压次数、嗜睡、皮肤瘙痒等不良反应发生率比较差异无统计学意义(P>0.05)。结论:纳布啡应用于小儿尿道下裂成形术的镇痛、镇静效果好,患儿复苏期平稳,不良反应少。Objective: To probe into the effects of nalbuphine on postoperative analgesia and sedation in children with hypospadias surgery. Methods: Totally 60 children admitted into our hospital from Jun. 2017 to Dec. 2018 were divided into the nalbufine group(group N), the tramadol group(group T) and the blank control group(group C) via the random number table, with 20 cases in each group. Fifteen minutes before the end of surgery, group N received intravenous nalbuphine 0.2 mg/kg, group T was treated with intravenous tramadol 1.0 mg/kg, and group C was given intravenous saline 2.0 mL. The clinical efficacy of three groups was analyzed. Results: The CHEOPS pain scores of group N and group T were significantly lower than those of group C at 4 h(T1), 8 h(T2), 12 h(T3), 24 h(T4) and 48 h(T5) after surgery(P<0.05). The CHEOPS pain score of group N was lower than that of group T at different time points. Ramsay sedation scores of group N were respectively(3.0±0.6) points,(2.9±0.6) points,(2.9±0.7) points,(2.7±0.6) points and(2.5±0.7) points at T1, T2, T3, T4 and T5, significantly higher than those in group T and group C(P<0.05). Ramsay sedation scores of group T were respectively(2.1±0.5) points,(2.0±0.6) points and(2.0±0.6) at T1, T2 and T3, significantly higher than those in group C(P<0.05). There was no statistically significant difference in heart rate(HR) and blood oxygen saturation(SpO2) among three groups at different time points(P>0.05). The incidence of nausea and vomiting in group C was significantly higher than that in group N and group T(P<0.05), and there was no statistically significant difference in the incidence of adverse drug reactions such as respiratory depression, dizziness and headache, times of patient-controlled intravenous analgesia(PCIA), drowsiness and skin pruritus among three groups(P>0.05). Conclusion: The application of nalbuphine in hypospadias surgery in children has good analgesic and sedative effects, and the recovery period of children is stable with few adverse drug reactions.

关 键 词：小儿 尿道下裂成形术 纳布啡 CHEOPS疼痛评分 RAMSAY镇静评分 

分 类 号：R726.9[医药卫生—儿科]