纳布啡对全子宫切除术患者术后睡眠质量的影响  

Effect of nalbuphine on postoperative sleep quality in patients undergoing total hysterectomy

作　　者：单士超 马焱 冯继峰[1] 彭伟[1] 麦叶丽 SHAN Shi-chao;MA Yan;FENG Ji-feng;PENG Wei;MAI Ye-li(Department of Anesthesiology,Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning 530000,Guangxi,China)

机构地区：[1]广西壮族自治区妇幼保健院麻醉科,广西南宁530000

出　　处：《川北医学院学报》2022年第10期1280-1283,共4页Journal of North Sichuan Medical College

基　　金：广西医学高层次骨干人才“139”计划(G202002015)。

摘　　要：目的:探讨纳布啡复合舒芬太尼自控静脉镇痛(PCIA)对腹腔镜全子宫切除术患者术后睡眠质量的影响。方法:腹腔镜全子宫切除术患者120例,按术后镇痛方式不同分为对照组(n=60)和观察组(n=60);两组术后均连接PCIA泵,对照组配方为舒芬太尼2.0μg/kg+托烷司琼10 mg,观察组配方为在对照组基础上加用纳布啡0.4 mg/kg。分别于术前1 d和术后1、3、5 d对患者行匹兹堡睡眠指数量表(PSQI)来评价患者睡眠质量,应用酶联免疫吸附法对患者晨尿中的褪黑素水平进行测定;记录两组术后6、24、48 h内舒芬太尼用量;记录两组术后48 h内不良反应;并于术后1 d和2 d采用康复质量评定量表(QoR-15)对患者术后恢复质量进行评价。结果:术后1 d和3 d,两组的PSQI评分相比术前1 d均增高(P<0.05),尿褪黑素水平相比术前1 d均降低(P<0.05);组间对比,观察组PSQI评分均低于对照组(P<0.05),尿褪黑素水平高于对照组(P<0.05)。相比对照组,观察组术后6、24、48 h舒芬太尼用量均减少(P<0.05),术后48 h内恶心呕吐发生率降低(P<0.05),术后1 d和2 d QoR-15评分增高(P<0.05)。结论:纳布啡复合舒芬太尼PCIA有助于改善腹腔镜全子宫切除术患者术后睡眠质量,促进术后恢复。Objective:To investigate the effect of nalbuphine combined with sufentanil patient-controlled intravenous analgesia(PCIA)on postoperative sleep quality in patients undergoing laparoscopic total hysterectomy.Methods:A total of 120 patients with laparoscopic total hysterectomy were divided into control group(n=60)and observation group(n=60)according to the different postoperative analgesia methods.Both groups were connected with PCIA pump after operation.The control group was given sufentanil 2.0μg/kg+tropisetron 10 mg.The observation group was treated with nalbuphine 0.4 mg/kg on the basis of the control group.The Pittsburgh Sleep Quality Index(PSQI)was used to evaluate the sleep quality of the patients 1 d before operation and 1,3,5 d after operation.The level of melatonin in the morning urine of the patients was measured by enzyme-linked immunosorbent assay.The dosage of sufentanil within 6,24 and 48 h after operation was recorded in the two groups.Adverse reactions within 48 h after operation were recorded in the two groups,the QoR-15 was used to evaluate the postoperative recovery quality of patients on the 1 and 2 d after operation.Results:At 1 and 3 d after operation,PSQI scores of the two groups were higher than those at 1 d before operation(P<0.05),and urinary melatonin levels were lower than those at 1 d before operation(P<0.05).The PSQI score of the observation group was lower than that of the control group(P<0.05),and the level of urinary melatonin was higher than that of the control group(P<0.05).Compared with the control group,the dosage of sufentanil in the observation group was reduced at 6,24 and 48 h after operation(P<0.05).The incidence of nausea and vomiting within 48 h after operation in the observation group was decreased(P<0.05),and the QoR-15 scores on 1 d and 2 d after operation were increased(P<0.05).Conclusion:Nebuphine combined with sufentanil PCIA is helpful to improve the postoperative sleep quality of patients with laparoscopic hysterectomy and promote postoperative recovery.

关 键 词：纳布啡 舒芬太尼 自控静脉镇痛 全子宫切除术 睡眠质量 

分 类 号：R614.3[医药卫生—麻醉学]