川北医学院学报2025，Vol.40Issue(10)：1253-1258,6.DOI:10.3969/j.issn.1005-3697.2025.10.007
纳布啡作为局麻药佐剂用于老年患者全髋关节置换术后神经阻滞镇痛的临床研究
Clinical study of Nalbuphine as local anesthetic adjuvant for nerve block analgesia in elderly patients after total hip arthroplasty
摘要
Abstract
Objective:To observe the effect of ultrasound-guided suprainguinal fascia iliaca compartment block(U-SFICB)with ropivacaine combined with different doses of nalbuphine on analgesia in elderly patients after total hip arthroplasty(THA).Methods:101 elderly patients with unilateral THA under general anesthesia were divided into four groups according to different anesthesia regimens:100 mg ropivacaine+normal saline group(R group,n=26),100 mg ropivacaine+10 mg nal-buphine group(LN group,n=25),and 100 mg ropivacaine+15 mg nalbuphine group(MN group,n=25),and 100 mg ropiv-acaine+20mg nalbuphine group(HN group,n=25),all were diluted to 30 mL with 0.9%sodium chloride injection.All four groups underwent U-SFICB in the post-anesthesia care unit(PACU),and sufentanil was used for patient-controlled intravenous analgesia after surgery.Comparison between groups of postoperative 4,8,12,24,and 48 h of resting and motion state of Numer-ical rating scale(NRS).Each group received 12 h preoperatively,12 and 24 h postoperatively,Interleukin 6(IL-6),Tumor nec-rosis factor-α(TNF-α),Interleukin 10(IL-10)concentration,the first start time of postoperative analgesia pump and 48 h of sufentanil use in each group,the early postoperative recovery of each group,and the occurrence of analgesia related adverse reac-tions 48 h after surgery were compared between groups.Results:Compared with R group and LN group,NRS score in MN and HN group was decreased at all time points(P<0.05),IL-6 and TNF-α concentrations were decreased at all time points(P<0.05),IL-10 concentrations were increased at all time points(P<0.05),and the start-up time of postoperative analgesia pump was significantly extended(P<0.05).The amount of sufentanil was significantly decreased 48 hours after operation(P<0.05).Compared with R group,LN group and HN group,the time of first anal exhaust and getting out of bed in MN group were significantly shortened(P<0.05).The incidence of adverse reactions was significantly decreased 48 h after operation(P<0.05).Compared with HN group,the start-up time of postoperative analgesic pump in MN group was significantly short-ened(P<0.05),and the overall incidence of adverse reactions was the lowest at 48 h after surgery(P<0.05).Conclusion:15 mg nalbuphine combined with ropivacaine can significantly prolong the duration of U-SFICB analgesia after THA in elderly pa-tients,and the first postoperative anal exhaust time and the first time of getting out of bed activity are the shortest,and the inci-dence of adverse reactions is the lowest within 48 hours after surgery,which can be clinically promoted and applied.关键词
全髋关节置换术/髂筋膜间隙阻滞/炎性因子/纳布啡/术后镇痛Key words
Total hip arthroplasty/Fascia iliaca compartment block/Inflammatory factor/Nalbuphine/Postoperative anal-gesia分类
医药卫生引用本文复制引用
王华娟,刘骐毓,刘静,李明明,宋满,李凤娟,郑孝振..纳布啡作为局麻药佐剂用于老年患者全髋关节置换术后神经阻滞镇痛的临床研究[J].川北医学院学报,2025,40(10):1253-1258,6.基金项目
河南省医学科技攻关联合共建项目(LHGJ20220656) （LHGJ20220656）
