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纳布啡混合氟比洛芬酯用于妇科腹腔镜术后PCIA的适宜配伍:多中心、随机、对比研究

Optimum compatibility of nabufine mixed with flurbiprofen for patient-controlled intravenous analgesia after gynecological laparoscopic surgery:a multicenter,randomized,controlled clinical trial
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摘要 目的评价纳布啡混合氟比洛芬酯用于妇科腹腔镜术后PCIA的适宜配伍。方法选择全身麻醉下妇科腹腔镜术患者210例,年龄18~64岁,BMI18~30 kg/m^2,ASA分级Ⅰ或Ⅱ级。采用随机数字表法分为4组:舒芬太尼2.0μg/kg+氟比洛芬酯2.0 mg/kg组(SF组,n=55)、纳布啡1.5 mg/kg+氟比洛芬酯2.0 mg/kg组(N1F组,n=49)、纳布啡2.0 mg/kg+氟比洛芬酯2.0 mg/kg组(N2F组,n=55)和纳布啡3.0 mg/kg+氟比洛芬酯2.0 mg/kg组(N3F组,n=51)。术后按照分组情况进行PCIA药物配制,背景剂量2.0 ml/h,PCA剂量1.0 ml,锁定时间15 min。SF组和N1F组-N3F组分别静脉注射舒芬太尼5.0μg或纳布啡5.0 mg进行补救镇痛,维持术后48 h静态VAS评分<4分。于入PACU(T1)、出PACU(T2)、术后6 h(T3)、24 h(T4)、48 h(T5)时记录Ramsay评分,记录术后0~6 h、6~24 h和24~48 h PCIA总按压次数和补救镇痛情况,记录术后48 h恶心、呕吐、嗜睡、寒战等不良反应发生率。结果与SF组比较,N1F组和N2F组恶心和呕吐发生率降低,N2F和N3F组补救镇痛率降低,总按压次数减少,N3F组T3,4时Ramsay评分升高(P<0.05);与N1F组比较,N2F和N3F组补救镇痛率降低,总按压次数减少,N3F组恶心和呕吐发生率、T3,4时点Ramsay评分增高(P<0.05);与N2F组比较,N3F组恶心和呕吐发生率升高(P<0.05),补救镇痛率、总按压次数、Ramsay评分差异无统计学意义(P>0.05)。结论纳布啡2.0 mg/kg混合氟比洛芬酯2.0 mg/kg为妇科腹腔镜术后PCIA的适宜配伍。 Objective To evaluate the optimum compatibility of nabufine mixed with flurbiprofen for patient-controlled intravenous analgesia(PCIA)after gynecological laparoscopic surgery.Methods A total of 210 patients,aged 18-64 yr,with body mass index of 18-30 kg/m^2,of American Society of Anesthesiologist physical statusⅠorⅡ,scheduled for gynecological laparoscopic surgery under general anesthesia,were divided into 4 groups using a random number table method:sufentanil 2.0μg/kg+flurbiprofen axetil 2.0 mg/kg group(SF group,n=55),nalbuphine 1.5 mg/kg+flurbiprofen axetil 2.0 mg/kg group(N1F group,n=49),nalbuphine 2.0 mg/kg+flurbiprofen axetil 2.0 mg/kg group(N2F group,n=55)and nalbuphine 3.0 mg/kg+flurbiprofen axetil 2.0 mg/kg group(N3F group,n=51).PCIA solution was prepared correspondingly after surgery in each group.The PCA pump was set up to deliver a 1 ml bolus dose with a 15-min lockout interval and background infusion at 2.0 ml/h.Nalbuphine 5 mg or sufentanil 5μg was intravenously injected as a rescue analgesic to maintain visual analogue scale score at rest<4 at 48 h after surgery in SF and N1F-N3F groups.Ramsay sedation scores were recorded on admission to post-anesthesia care unit(T1),at the time of post-anesthesia care unit discharge(T2)and at 6,24 and 48 h after surgery(T3-5).The total pressing times of PCIA in 0-6 h,6-24 h and 24-48 h periods after surgery and requirement for rescue analgesics were recorded.The incidence of adverse reactions such as nausea and vomiting,drowsiness and shivering within 48 h after surgery was also recorded.Results Compared with group SF,the incidence of nausea and vomiting was significantly decreased in N1F and N2F groups,the requirement for rescue analgesics was significantly decreased,and the total pressing times of PCIA was reduced in N2F and N3F groups,and Ramsay sedation scores at T3,4 were significantly increased in group N3F(P<0.05).Compared with group N1F,the requirement for rescue analgesics was significantly decreased,and the total pressing times of PCIA was reduced
作者 刘越 梁燕冰 宋兴荣 杜卫东 刘吉平 刘先保 陈岱莉 胡洪涛 徐世元 雷洪伊 Liu Yue;Liang Yanbing;Song Xingrong;Du Weidong;Liu Jiping;Liu Xianbao;Chen Daili;Hu Hongtao;Xu Shiyuan;Lei Hongyi(Department of Anesthesiology,Zhujiang Hospital of Southern Medical University,Guangzhou 510220,China;Department of Anesthesiology,Huizhou Hospital of Guangzhou Medical University,Huizhou 516000,China;Department of Anesthesiology,Guangzhou Women and Children′s Medical Center,Guangzhou 510220,China;Department of Anesthesiology,Huizhou Second Maternal and Child Health Hospital,Huizhou 516000,China;Department of Anesthesiology,Foshan Maternal and Child Health Hospital,Foshan 528000,China;Department of Anesthesiology,The Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510220,China;Department of Anesthesiology,Shenzhen Maternal and Child Health Hospital,Shenzhen 518000,China;Department of Anesthesiology,Hexian Memorial Affiliated Hospital of Southern Medical University,Guangzhou 510220,China)
出处 《中华麻醉学杂志》 CAS CSCD 北大核心 2019年第2期185-188,共4页 Chinese Journal of Anesthesilolgy
关键词 纳布啡 氟比洛芬 镇痛 病人控制 腹腔镜检查 Nalbuphine Flurbiprofen Analgesia,patient-controlled Laparoscopy
作者简介 通信作者:雷洪伊,Email:leihongyi2012@163.com.
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