纳布啡对小儿唇腭裂手术麻醉及镇痛效果的影响  

Effects of Nalbuphine on Anesthesia and Analgesia in Pediatric Cleft Lip and Palate Surgery

作　　者：同鑫 张明军 周晓军 金冉[1] 代志恒 聂艳芳 TONG Xin;ZHANG Mingjun;ZHOU Xiaojun;JIN Ran;DAI Zhiheng;NIE Yanfang(Department of Anesthesiology,Zhengzhou First People’s Hospital,Zhengzhou 450004,China;Plastic Surgery,Zhengzhou First People’s Hospital,Zhengzhou 450004,China)

机构地区：[1]郑州市第一人民医院麻醉科,河南郑州450004 [2]郑州市第一人民医院整形外科,河南郑州450004

出　　处：《河南医学研究》2024年第9期1594-1597,共4页Henan Medical Research

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20220815)。

摘　　要：目的探究纳布啡对小儿唇腭裂手术麻醉及镇痛效果的影响。方法选取2019年3月至2023年3月在郑州市第一人民医院接受手术治疗的78例唇腭裂小儿作为研究对象,使用随机抽签法分为对照组(39例)和纳布啡组(39例)。纳布啡组麻醉诱导前推注0.2 mg·kg^(-1)纳布啡,给予对照组罗库溴铵、丙泊酚、舒芬太尼进行麻醉诱导。记录两组苏醒时间、自主呼吸恢复时间;以镇静评分量表、疼痛评估量表评估患者拔管后30 min(T_(0))、1 h(T_(1))、2 h(T_(2))、4 h(T_(3))镇静、镇痛效果;从患儿术前、术毕、术后30 min生命体征变化情况评估患儿麻醉效果。结果纳布啡组苏醒时间、自主呼吸恢复时间低于对照组(P<0.05)。两组镇静评分、镇痛评分主效应、时间效应、交互效应有统计学意义(P<0.05);进一步两两比较,组内比较,两组T_(1)、T_(2)、T_(3)镇静评分、镇痛评分均较T_(0)下降;组间比较,纳布啡组T_(0)、T_(1)、T_(2)、T_(3)时镇静评分高于对照组,镇痛评分低于对照组(P<0.05)。两组血氧饱和度、呼吸主效应、时间效应、交互效应无统计学意义(P>0.05)。两组心率、平均动脉压处理主效应、时间主效应、交互效应有统计学意义(P<0.05);进一步两两比较,组内比较,对照组术毕及术后30 min心率、平均动脉压均较术前升高,组间比较,纳布啡组术毕及术后30 min心率、平均动脉压低于对照组(P<0.05)。纳布啡组躁动、呼吸道分泌液增多、呼吸抑制等发生率(5.13%)低于对照组(25.64%)(P<0.05)。结论纳布啡用于小儿唇腭裂手术可有效维持生命体征,缩短苏醒时间,镇痛、镇静效果更好,安全性较高。Objective To explore the effect of nalbuphine on anesthesia and analgesia in children with cleft lip and palate.Methods A total of 78 children with cleft lip and palate who underwent surgery in Zhengzhou First People’s Hospital from March 2019 to March 2023 were selected as the research objects and were divided into control group(39 cases)and nalbuphine group(39 cases)by random lottery.The nalbuphine group was injected with 0.2 mg·kg^(-1) nalbuphine before anesthesia induction,while the control group was given rocuronium,propofol and sufentanil for anesthesia induction.The awakening time and spontaneous breathing recovery time of the two groups were recorded.Sedation and analgesia effects were evaluated by sedation score scale and pain assessment scale 30 minutes(T_(0)),1 hour(T_(1)),2 hours(T_(2)),and 4 hours(T_(3))after extubation.The anesthesia effect was evaluated from the changes of vital signs before operation,at the end of operation,and 30 min after operation.Results The awakening time and spontaneous breathing recovery time of the nalbuphine group were lower than those of the control group(P<0.05).There were stastistical differences in sedation score,analgesia score main effect,time effect and interaction effect between the two groups(P<0.05).Further pairwise comparison,intra-group comparison,sedation score and analgesia score of the two groups at T_(1),T_(2),T_(3) were lower than those at T_(0),inter-group comparison,sedation score of the nalbuphine group at T_(0),T_(1),T_(2),T_(3) was higher than that of the control group,and analgesia score was lower than that of the control group(P<0.05).There were no stastistical differences in blood oxygen saturation,respiratory main effect,time effect and interaction effect between the two groups(P>0.05).There were stastistical differences in heart rate,mean arterial pressure main effect,time main effect and interaction effect between the two groups(P<0.05).Further pairwise comparison,intra-group comparison,heart rate and mean arterial pressure of the control gr

关 键 词：唇腭裂 纳布啡 镇痛效果 生命体征 

分 类 号：R782.21[医药卫生—口腔医学]