纳布啡与舒芬太尼分别用于腹腔镜下全子宫切除术后镇痛、镇静的效果比较

摘要

OBJECTIVE:To probe into the postoperative analgesia effects of nalbuphine and sulfentanil on patients after laparoscopic total hysterectomy .METHODS:90 patients undergoing laparoscopic total hysterectomy admitted from Jun .to Dec.2016 were extracted to be divided into mixed group , nalbuphine group and sulfentanil group via the random number table, with 30 cases in each.The mixed group was given sufentanil combined with nalbuphine , the nalbuphine group was treated with nalbuphine and the sulfentanil group received sufentanil .Changes of visual analogue scale (VAS) and Ramsay sedation score and incidence of adverse drug reactions of three groups were observed after treatment of 2, 4, 8, 12, 24, 36 and 48 h.RESULTS:After treatment of 12, 24, 36 and 48 h, the VAS score of mixed group was significantly higher than that of sulfentanil group and nalbuphine group , with statistically significant difference ( P<0.05).The Ramsay sedation score of nalbuphine group and sulfentanil group were significantly higher than those of mixed group , and the nalbuphine group was higher than the sulfentanil group, with statistically significant difference (P<0.05).The incidence of adverse drug reactions of sulfentanil group was significantly higher than that of mixed group and nalbuphine group , with statistically significant difference ( P <0.05 ) .CONCLUSIONS:The postoperative analgesia effects of nalbuphine on patients after laparoscopic total hysterectomy are better than those of sulfentanil and nalbuphine combined with sulfentanil , and the incidence of adverse drug reactions is lower than that of sulfentanil , meanwhile, it has better analgesia and sedation effects with higher safety.%目的:比较纳布啡与舒芬太尼分别用于腹腔镜下全子宫切除术后镇痛、镇静的效果.方法:选择2016年6—12月择行期腹腔镜下全子宫切除术的患者90例作为研究对象,按随机数字表法分为混合组、纳布啡组和舒芬太尼组,每组30例.混合组患者给予舒芬太尼联合纳布啡,纳布啡组患者给予纳布啡,舒芬太尼组患者给予舒芬太尼,观察三组患者术后2、4、8、12、24、36和48 h的视觉模拟镇痛(visual analogue scale,VAS)评分、Ramsay镇静评分变化及不良反应发生情况.结果:术后12、24、36和48 h,混合组患者的VAS评分明显高于舒芬太尼组和纳布啡组,差异均有统计学意义(P<0.05).术后8、12、24、36和48 h,纳布啡组和舒芬太尼组患者的Ramsay镇静评分明显高于混合组,且纳布啡组明显高于舒芬太尼组,差异均有统计学意义(P<0.05).舒芬太尼组患者不良反应发生率明显高于混合组和纳布啡组,差异均有统计学意义(P<0.05).结论:纳布啡用于腹腔镜下全子宫切除术后镇痛、镇静的效果明显优于舒芬太尼、纳布啡联合舒芬太尼,不良反应发生率明显低于舒芬太尼,其镇痛、镇静效果较好,安全性较高.