纳布啡与瑞芬太尼联合用于急诊创伤患者镇静镇痛的效果  

Effect of nalbuphine combined with remifentanil on sedation and analgesia in patients with emergency trauma

作　　者：任乐宁 李大欢 张国秀[1] 夏征 Ren Lening;Li Dahuan;Zhang Guoxiu;Xia Zheng(Department of Emergency Medicine,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China)

机构地区：[1]河南科技大学第一附属医院急诊医学部,洛阳471003 [2]河南推拿职业学院针灸推拿系,洛阳471023

出　　处：《中国实用医刊》2023年第17期54-57,共4页Chinese Journal of Practical Medicine

摘　　要：目的:观察纳布啡联合瑞芬太尼用于急诊创伤患者镇静镇痛的效果。方法:抽取2021年10月至2022年9月河南科技大学第一附属医院急诊科收治的91例创伤患者作为研究对象,按照入院顺序分为常规组(45例)与联合组(46例)。常规组予以瑞芬太尼,联合组予以纳布啡联合瑞芬太尼。比较两组用药前后循环、呼吸参数[平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2))、呼吸频率(RR)、中心静脉压(CVP)]、视觉模拟评分法(VAS)评分、Rasmay镇静评分,皮质醇、β-内啡肽水平,比较两组不良反应发生率。结果:用药后4、8 h,联合组MAP、HR、RR均高于常规组(P均<0.05);用药后4、8 h,联合组VAS评分低于常规组(P<0.05);用药后4、8 h,联合组Rasmay镇静评分高于常规组(P<0.05);用药后4、8 h,联合组皮质醇、β-内啡肽水平高于常规组(P<0.05)。两组不良反应发生率比较差异未见统计学意义(P>0.05)。结论:急诊创伤患者救治中应用纳布啡联合瑞芬太尼的镇静镇痛效果明显,可减轻应激反应。Objective To observe the effects of nalbuphine combined with remifentanil on sedation and analgesia in patients with emergency trauma.Methods Ninety-one trauma patients admitted to the Department of Emergency Medicine in the First Affiliated Hospital of Henan University of Science and Technology from October 2021 to September 2022 were selected as study subjects,and they were divided into conventional group(45 cases)and combined group(46 cases)according to the order of admission.The conventional group was given remifentanil,and the combined group was given nalbuphine combined with remifentanil.Circulatory and respiratory parameters,including mean arterial pressure(MAP),heart rate(HR),oxygen saturation(SpO_(2)),respiratory rate(RR)and central venous pressure(CVP),pain visual analogue scale(VAS)score,Rasmay sedation score,cortisol,β-endorphin and incidence of adverse effects were compared between the two groups.Results MAP,HR and RR in the combined group were higher than those in the conventional group 4 and 8 hours after drug administration(all P<0.05).The VAS score in the combined group was lower than that in the conventional group 4 and 8 hours after drug administration(P<0.05).Rasmay sedation score in the combined group was higher than that in the conventional group 4 and 8 hours after drug administration(P<0.05).The levels of cortisol andβ-endorphin in the combined group were higher than those in the conventional group 4 and 8 hours after drug administration(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Nalbuphine combined with remifentanil has great sedative and analgesic effect in the treatment of emergency trauma patients,and it can reduce the stress response.

关 键 词：纳布啡 瑞芬太尼 急诊 创伤 

分 类 号：R641[医药卫生—外科学]