舒芬太尼与纳布啡静脉自控镇痛在肝癌患者腹腔镜下肝切除术中的应用效果比较  

Application of sufentanil and nalbuphine in patient-controlled intravenous analgesia in laparoscopic hepatectomy for liver cancer

作　　者：靳珂 Jin Ke(Department of Anesthesiology,Henan Rongjun Hospital,Xinxiang 453000,China)

机构地区：[1]河南省荣军医院麻醉科,新乡453000

出　　处：《中国实用医刊》2022年第3期54-57,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较舒芬太尼与纳布啡静脉自控镇痛(PCIA)在肝癌患者腹腔镜下肝切除术中的应用效果。方法回顾性分析河南省荣军医院2019年1月至2020年12月收治的106例肝癌手术患者的临床资料,根据应用的麻醉药物分为对照组(舒芬太尼,53例)和观察组(纳布啡,53例)。两组均行腹腔镜下肝切除术治疗,于术后6、12、24 h以视觉模拟评分法(VSA)评估两组镇痛情况,并比较两组术后24 h用药情况及术后不良反应发生情况。结果术后12、24 h,两组VAS评分均低于术后6 h,且术后24 h VAS评分低于术后12 h,差异均有统计学意义(P均<0.05);两组各时点VAS评分比较,差异有统计学意义(调整后P均<0.017)。术后24 h内,观察组镇痛泵用药总量低于对照组,按压总次数少于对照组(P<0.05)。观察组术后呼吸抑制发生率(1.89%,1/53)低于对照组(15.09%,8/53),P<0.05;两组术后呕吐、皮肤瘙痒发生率比较,差异未见统计学意义(P>0.05)。结论与舒芬太尼比较,纳布啡PCIA在肝癌患者腹腔镜下肝切除术中镇痛效果更好,且用药总量更少,安全性更好。Objective To compare the application effects of sufentanil and nalbuphine in patient-controlled intravenous analgesia(PCIA)in laparoscopic hepatectomy for liver cancer.Methods The clinical data of 106 patients with liver cancer surgery treated in Henan Rongjun Hospital from January 2019 to December 2020 were retrospectively analyzed.Patients were divided into control group(sufentanil,53 cases)and observation group(nalbuphine,53 cases)according to anesthetic drugs.Laparoscopic hepatectomy was performed on both groups,the analgesia was evaluated in the two groups at 6,12 and 24 hours after operation.And the medication at 24 hours after operation and the occurrence of postoperative adverse reactions of the two groups were compared.Results The VAS scores at 12 and 24 hours after operation in both groups were lower than those at 6 hours after operation,and the VAS score at 24 hours after operation were lower than those at 12 hours after operation(all P<0.05).There was a significant difference in VAS score between the two groups at each time point(P<0.017 after adjustment).Compared with the control group,the total amount of analgesic pump used in the observation group within 24 hours after operation was lower,and the total times of pressing was less(P<0.05).The incidence of postoperative respiratory depression in the observation group(1.89%,1/53)was lower than that in the control group(15.09%,8/53),P<0.05;there was no statistical significant difference in the comparison of the incidence of postoperative vomiting and pruritus of both groups(P>0.05).Conclusions Compared with sufentanil,the analgesic effect of nalbuphine PCIA has better effects in laparoscopic hepatectomy for liver cancer,and the total amount of medication is less,and the safety is higher.

关 键 词：肝癌 舒芬太尼 纳布啡 静脉自控镇痛 

分 类 号：R614[医药卫生—麻醉学] R735.7[医药卫生—外科学]