纳布啡联合瑞芬太尼用于剖宫产术后静脉自控镇痛的效果
Effect of nalbuphine combined with remifentanil intravenous self-control on postoperative analgesia
冯定祥 1付梅苏 1羊瑛 1包丽霞 1王莹1
作者信息
- 1. 磐安县人民医院,浙江 磐安 322300
- 折叠
摘要
目的 评价纳布啡与瑞芬太尼联合麻醉用于剖宫产术后PCIA中的疗效及安全性.方法 选取 2023年 1～6 月在浙江省磐安县人民医院实施剖宫产手术的 96 例产妇,按随机数字表法分为瑞芬太尼组 48 例,术后行瑞芬太尼PCIA;联合组 48 例,术后行纳布啡联合瑞芬太尼PCIA.记录比较两组术后 3、6、9、12、24 小时咳嗽时VAS评分及Ramsay评分;术后 24 小时的PRL水平及术后泌乳启动时间;术后不良反应发生情况.结果 联合组术后 6、9 小时咳嗽时VAS评分低于瑞芬太尼组(P<0.01);联合组术后 24 小时的PRL水平高于瑞芬太尼组(P<0.01);联合组产妇产后泌乳水平(泌乳起始时间≤24 小时)优于瑞芬太尼组(P<0.05);联合组PCIA按压次数、恶心/呕吐发生率均少于瑞芬太尼组(P<0.05).结论 纳布啡联合瑞芬太尼用于剖宫产术后PCIA的镇痛效果理想,不良反应较轻,且对产妇术后PRL分泌的影响较少.
Abstract
Objective To evaluate the efficacy and safety of combined nabilone and remifentanil for postoperative pa-tient-controlled analgesia(PCIA)in cesarean section.Method A total of 96 parturients undergoing cesarean section at Pan'an People's Hospital of Zhejiang Province from January to June 2023 were randomly divided into two groups:the remifentanil group(n=48)and the nabilone-remifentanil group(n=48).Postoperative analgesia was provided by PCIA with remifentanil or a combination of nabilone and remifentanil,respectively.The primary outcome measures were the Visual Analog Scale(VAS)and Ramsay Sedation Score at 3,6,9,and 12 hours postoperatively,as well as the prolactin(PRL)level and time to lactation ini-tiation at 24 hours postoperatively.Secondary outcome measures included the incidence of adverse events.Result Compared with the remifentanil group,the nabilone-remifentanil group had significantly lower VAS scores at 6 and 9 hours postopera-tively(P<0.01),higher PRL levels at 24 hours postoperatively(P<0.01),and an earlier onset of lactation(within 24 hours)(P<0.05).Moreover,the nabilone-remifentanil group had significantly fewer PCIA bolus requests and incidences of nausea and vomiting(P<0.05).Conclusion The combination of nabilone and remifentanil for postoperative PCIA in cesarean section pro-vides ideal analgesia with fewer adverse effects and has minimal impact on postpartum PRL secretion.
关键词
剖宫产/PCIA/纳布啡/瑞芬太尼Key words
cesarean section/PCIA/nabilone/remifentanil引用本文复制引用
出版年
2024
NETL
NSTL
万方数据