中南医学科学杂志2025，Vol.53Issue(2)：276-279,4.DOI:10.15972/j.cnki.43-1509/r.2025.02.020
不同剂量纳布啡联合瑞芬太尼自控镇痛在剖宫产术后的应用
Application of different doses of nalbuphine combined with remifentanil in self-controlled an-algesia after cesarean section
摘要
Abstract
Aim To study the use of different doses of nalbuphine combined with remifentanil for self-controlled analgesia af-ter cesarean section.Methods Totally 78 postpartum women who underwent cesarean section in our hospital were divided into low-dose(1.2 mg/kg),medium-dose(2.2 mg/kg),and high-dose groups(3.2 mg/kg)based on the use of different doses of nalbu-phine.After surgery,each group was given corresponding doses of nalbuphine combined with 0.3 μg/kg remifentanil.The analge-sic effect(Visual Analog Scale(VAS))and sedative effect(Ramsay score)of each group were observed after 1 hour and 12 hours of administration.The heart rate(HR),mean arterial pressure(MAP),prolactin(PRL),and plasma cortisol(Cor)levels of each group before surgery,1 hour after administration,and 6 hours after administration were compared.The occurrence of adverse reac-tions during the treatment process was recorded.Results After 12 h of administration,VAS scores in the high-dose group,medi-um-dose group,and low-dose group increased sequentially(P＜0.05),while Ramsay scores decreased sequentially(P＜0.05).After 1 h of administration,the serum PRL levels in all groups were higher than the levels before surgery,and the medium-dose group was higher than the low-dose group and high-dose group(P＜0.05);the plasma Cor levels in all groups were lower than the levels be-fore surgery,with the medium-dose group being lower than the low-dose and high-dose groups(P＜0.05).The HR and MAP levels in the low-dose and high-dose groups increased with time(P＜0.05);After 6 h of administration,the HR and MAP levels in the medi-um dose group were lower than those in the low-dose and high-dose groups(P＜0.05),and the low-dose group was lower than the high-dose group(P＜0.05).The incidence of adverse reactions in the high-dose group was higher than that in the low-dose and medium dose groups(P＜0.05).Conclusion When the dose of nalbuphine is 2.2 mg/kg,the combination of remifentanil has the best sedative and analgesic effect after cesarean section,which can maintain hemodynamic stability,inhibit stress response,and reduce the incidence of adverse reactions.It is a safe and effective postoperative analgesia plan for cesarean section.关键词
纳布啡/瑞芬太尼/自控镇痛/剖宫产Key words
nalbuphine/remifentanil/self-controlled analgesia/cesarean section分类
临床医学引用本文复制引用
黄岩,王丽霞,张莹莹..不同剂量纳布啡联合瑞芬太尼自控镇痛在剖宫产术后的应用[J].中南医学科学杂志,2025,53(2):276-279,4.基金项目
安徽省重点研究与开发计划(202104j07020013) （202104j07020013）
