【摘要】 目的观察盐酸纳布啡用于口腔颌面部骨折术后自控静脉镇痛(PCIA)的效果和安全性。方法选择120例择期行口腔颌面部骨折切开复位内固定的患者,随机分为纳布啡组(N组)、舒芬太尼组(S组)、舒芬太尼联合纳布啡组(SN组),术后均接受自控静脉镇痛治疗,每组40例。N组镇痛配方为:盐酸纳布啡注射液2 mg/kg+昂丹司琼8 mg+0.9%氯化钠注射液至100 mL;S组为枸橼酸舒芬太尼注射液2 mg/kg,余同N组;SN组为盐酸纳布啡注射液1 mg/kg+枸橼酸舒芬太尼注射液1 mg/kg,余同N组。观察患者术后2、4、8、12、24、48 h各时点疼痛视觉模拟评分(visual analogue scale,VAS)、Ramsay镇静评分(Ramsay sedation score,RSS)、患者满意度、恶心呕吐等不良反应的发生率。结果 3组配方均能为患者提供良好的术后镇痛,3组患者VAS评分、RSS评分,差异无统计学意义。N组及SN组患者术后的总体满意度显著优于S组(P<0.05),且恶心呕吐等不良反应更少。N组与SN组各项指标差异无统计学意义(P>0.05)。结论纳布啡以及纳布啡联合舒芬太尼用于口腔颌面部骨折PCIA,镇痛效果确切、恶心呕吐等发生率低、患者满意度高,值得临床推广。更多还原

【Abstract】 Objective To observe the efficacy and safety of Nalbuphine for postoperative controlled intravenous analgesia( PCIA) in patients with maxillofacial fractures. Methods 120 patients with oral and maxillofacial fractures were randomly divided into three groups comprising 40 patients: Nalbuphine group( N group),Sufentanil group( S group),Sufentanil combined with Nalbuphine group( SN group),for PCIA treatment respectively.Observe the incidence of visual analog score( VAS),Ramsay sedation scores( RSS),patient satisfaction,the incidence of adverse reactions such as nausea and vomiting at postoperation 2,4,8,12,24,48 h after surgery.Results Three sets of formula can provide patients with good postoperative analgesia. VAS and RSS were not statistically significant( P > 0. 05). The overall satisfaction of patients in group N and SN was significantly superior to that in group S( P < 0. 05),with less adverse reactions such as nausea and vomiting. There has no significant difference between N group and SN group( P > 0. 05). Conclusion Nalbuphine and nalbuphine combined with sufentanil for oral and maxillofacial fractures PCIA,not only have good effect of analgesia,but also reduce the incidence of nausea and vomiting,and patient’s satisfaction is high as well worthy of clinical promotion.更多还原