BACKGROUND Gastric cancer(GC)is a prevalent tumor in the digestive system,with around one million new cases reported annually,ranking it as the third most common malignancy.Reducing pain is a key research focus.This s...BACKGROUND Gastric cancer(GC)is a prevalent tumor in the digestive system,with around one million new cases reported annually,ranking it as the third most common malignancy.Reducing pain is a key research focus.This study evaluates the effect of nalbuphine on the analgesic effect and the expression of pain factors in patients after radical resection.AIM To provide a reference for postoperative analgesia methods.METHODS One hundred eight patients with GC,admitted between January 2022 and June 2024,underwent radical gastrectomy.They received a controlled analgesia pump and a transverse abdominis muscle plane block,divided into two groups of 54 patients in each group.The control group received sufentanil,while the observation group received nalbuphine as an analgesic.Postoperative analgesic effects,pain factor expression,and adverse effects were compared.RESULTS The resting pain and activity pain scores in the observation group at 6,12,24 and 48 hours were significantly lower than those in the control group.Additionally,the number of presses and consumption of the observation group at 48 hours were lower than those of the control group;and the response rate of the observation group was higher than that of the control group(P<0.05).The prostaglandin E2,substance P,and serotonin levels 24 hours after the observation group were lower than those in the control group,and the incidence of adverse reactions was 5.56%lower than 22.22%in the control group(P<0.05).CONCLUSION The findings suggest that nalbuphine enhances postoperative multimodal analgesia in patients with radical GC,effectively improving postoperative analgesic effect,relieving postoperative resting and active pain,and reducing postoperative pain factor expression,demonstrating its potential for clinical application.展开更多
This editorial highlights the randomized controlled trial by Qian et al evaluating the efficacy of nalbuphine in managing postoperative pain and associated inflammatory factors in patients undergoing radical gastrecto...This editorial highlights the randomized controlled trial by Qian et al evaluating the efficacy of nalbuphine in managing postoperative pain and associated inflammatory factors in patients undergoing radical gastrectomy for gastric cancer.Utilizing a multimodal analgesic approach with a controlled analgesia pump and a transverse abdominis muscle plane block,the study compared nalbuphine against sufentanil.Results indicate that nalbuphine significantly reduces pain scores at various postoperative intervals,decreases consumption and patientcontrolled analgesia presses,and lowers levels of pain markers such as prostaglandin E2,serotonin,and substance P.While both agents demonstrated effective pain control,nalbuphine was associated with a lower incidence of adverse effects,suggesting its potential as a valuable alternative in appropriate clinical scenarios.This study offers valuable insights into nalbuphine’s clinical applicability,underscoring its benefits for pain management and enhancing patient recovery in the postoperative setting.展开更多
BACKGROUND Radical laparoscopic gastrectomy is an important treatment modality for gastric cancer.Surgery requires general anesthesia,and patients are susceptible to the effects of anesthetic drugs and carbon dioxide ...BACKGROUND Radical laparoscopic gastrectomy is an important treatment modality for gastric cancer.Surgery requires general anesthesia,and patients are susceptible to the effects of anesthetic drugs and carbon dioxide insufflation during the procedure,leading to inflammation or severe pain,which can affect patient outcome.AIM To explore the efficacy of combining dexmedetomidine(DEX)with nalbuphine in patients underwent laparoscopic radical gastrectomy for gastric cancer.METHODS Patients scheduled to undergo laparoscopic radical gastrectomy were selected and randomly assigned to A or B group.In A group,patients received an intravenous injection of nalbuphine 0.2 mg/kg+DEX 0.4μg/kg 10 min before the end of surgery;in B group,patients received only an intravenous injection of nalbuphine.The trends in hemodynamic parameter fluctuations,awakening quality during the recovery period,serum inflammatory markers,agitation scores,cough severity,incidence,and duration of postoperative delirium(POD)were compared.RESULTS The mean arterial pressure and heart rate in the A group were more stable(P<0.05).The A group had a lower average awakening time,extubation time,and agitation scores during recovery than the B group.Agitation control in the A group was more effective at different time points(P<0.05).Patients in the A group had lower serum interleukin(IL)-6,tumour necrosis factor alpha,and IL-10 levels at 1 h after surgery than the B group.The incidence of coughing and duration of POD were lower and shorter in the A group than in the B group.Adverse reactions caused by the two anesthesia methods were less frequent in the A group than in the B group(P<0.05).CONCLUSION The use of DEX and nalbuphine in patients undergoing laparoscopic radical gastrectomy for gastric cancer help reducing the inflammatory response,cough severity,and agitation and helps maintain hemodynamic stability.展开更多
Background: Nalbuphine is a derivative of 14-hydroxymorphine which is a strong analgesic with mixed k agonist and μ antagonist. Nalbuphine was studied several times as adjuvant to local anesthetics in spinal, epidura...Background: Nalbuphine is a derivative of 14-hydroxymorphine which is a strong analgesic with mixed k agonist and μ antagonist. Nalbuphine was studied several times as adjuvant to local anesthetics in spinal, epidural and local intravenous block. The aim of this study was to evaluate the effect of nalbuphine as an adjuvant to local anesthetics in supraclavicular brachial plexus block. Patients and Methods: Fifty-six patients undergoing elective forearm and hand surgery under supraclavicular brachial plexus block were allocated randomly into one of two groups of 28 patients each to receive either 25 ml (0.5%) bupivacaine with 1 ml of NS or 25 ml (0.5%) bupivacaine with 1 ml (20 mg) nalbuphine. Onset time and duration of both sensory and motor block, and post-operative analgesia were observed. Result: Nalbuphine group showed significant increase in the duration of motor block (412.59 ± 18.63), when compared to control group (353.70 ± 29.019) p-value < 0.001, also, there was significant increase in sensory duration in nalbuphine group (718.14 ± 21.04) when compared to control group (610.18 ± 26.33) p-value < 0.001, without affecting the onset time of the blockade. And also, there was a significant increase in the duration of analgesic effect in nalbuphine group (835.18 ± 42.45) when compared to control group (708.14 ± 54.57) p-value < 0.001. Conclusion: The present study demonstrates that addition of 20 mg nalbuphine to bupivacaine in supraclavicular brachial plexus block is associated with significant increase in the duration of both sensory and motor block and also prolong the duration of analgesia.展开更多
Opioids are drugs used to alleviate pain. However, studies have demonstrated that these drugs can cause an increase in pain sensitivity, which is called opioid-induced hyperalgesia. The objective of this study was to ...Opioids are drugs used to alleviate pain. However, studies have demonstrated that these drugs can cause an increase in pain sensitivity, which is called opioid-induced hyperalgesia. The objective of this study was to describe the effects of dexamethasone, clonidine, tramadol and nalbuphine on fentanyl-induced hyperalgesia in rats. After obtaining approval from the Committee for the Ethical Use of Animals (CEUA), 36 male Wistar rats were divided into 6 groups: Group 1 (GCSSL) wherein the rats received 1 ml 0.9% saline solution in two injections;Group 2 (GFTSL), received fentanyl at a dose of 100 ug<span style="white-space:nowrap;">·</span>kg<sup>-1</sup> followed by 1 ml 0.9% saline solution via intraperitoneal;the remaining groups (3, 4, 5, 6) received fentanyl at a dose of 100 ug<span style="white-space:nowrap;">·</span>kg<sup>-1</sup> following doses via intraperitoneal: Group 3 (GFTDX), dexamethasone at a dose of 1.0 mg<span style="white-space:nowrap;">·</span>kg<sup>-1</sup>;Group 4 (GFTCL), clonidine at a dose of 20 mg<span style="white-space:nowrap;">·</span>kg<sup>-1</sup>;Group 5 (GFTTR), tramadol at a dose of 50 mg<span style="white-space:nowrap;">·</span>kg<sup>-1</sup>, and Group 6 (GFTNB), nalbuphine at a dose of 5 mg<span style="white-space:nowrap;">·</span>kg<sup>-1</sup>. Under general anestesia using isoflurane, the animals were submitted to a surgical incision. Hyperalgesia was evaluated by applying Von Frey filaments at 2 hours after the incision and on the 1<sup>st</sup>, 3<sup>rd</sup> and 5<sup>th</sup> days afterward. At 2 hours after the surgical procedure, there was lower intensity of pain in the fentanyl group (GFTSL) compared to the other groups, and on the fifth day there were no significant differences for pain intensity between groups. The results suggest the presence of fentanyl-induced hyperalgesia and efficacy in its reduction by dexamethasone, clonidine, tramadol and nalbuphine.展开更多
Intravenous Regional Anesthesia (IVRA) is easy to administer and reliable. But delayed onset and lack of postoperative analgesia are the major limitations. Accordingly, many additives have been tried. Dexmedetomidine ...Intravenous Regional Anesthesia (IVRA) is easy to administer and reliable. But delayed onset and lack of postoperative analgesia are the major limitations. Accordingly, many additives have been tried. Dexmedetomidine is a highly selective α-2 adrenoceptor agonist. Addition of dexmedetomidine to lignocaine is effective in decreasing the anesthetic requirements and prolonging the analgesic duration. On the other hand, many theories explain that opioids may exert their peripheral action through peripheral opioid receptors. The aim of the study was to compare the analgesic efficacy of nalbuphine and dexmedetomidine when used separately as adjuvants to lidocaine during IVRA with the effect of lidocaine alone. Sixty adult patients, who were scheduled for surgery of the hand or the forearm under intravenous regional anesthesia, were included in this study. The patients were randomly allocated into three equal groups. The syringes in all groups contained 3 mg/kg of lidocaine 0.5% diluted in 40 ml isotonic saline. Group C: Control group. Group D: Dexmedetomidine group, 1 mic/kg dexmedetomidine diluted was added. Group N: Nalbuphine group, 20 mg nalbuphine was added. Sensory onset time (min) as well as motor block onset time (min) were significantly shorter in Groups N (2.0 ± 1.7) (3.8 ± 2.1) respectively, and D (2.2 ± 1.8) (4.6 ± 2.2) respectively compared to Group C (3.6 ± 1.6) (7.1 ± 1.4) (P < 0.05), with no significant differences between nalbuphine and dexmedetomidine groups. Sensory and motor block recovery times (min) were significantly longer in Groups N (9.6 ± 0.7) (10.3 ± 1.2) and D (8.1 ± 1.1) (9.1 ± 2.1) when compared to Group C (3.4 ± 2.1) (3.7 ± 3.1) (P < 0.05), without significant differences between nalbuphine and dexmedetomidine. Ramsay sedation score was significantly higher (RSS = 2) in 14 patients (70%) in Group D compared to Groups C and N during the first 30 min after the release of tourniquet.展开更多
Objective: To study the effect of nalbuphine preemptive analgesia combined with ropivacaine local infiltration on postoperative incision pain, stress response and immune function in children. Methods: Children who rec...Objective: To study the effect of nalbuphine preemptive analgesia combined with ropivacaine local infiltration on postoperative incision pain, stress response and immune function in children. Methods: Children who received selective laparotomy in Mianyang Central Hospital between August 2015 and August 2017 were selected and randomly divided into control group, nalbuphine group (N group), ropivacaine group (R group) and nalbuphine + ropivacaine group (N+R group). The levels of pain and stress-related mediators in serum and the levels of immune cells in peripheral blood were detected before operation and 24 h after operation. Results: 24 h after operation, serum Cor, NE, MDA, SP, PGE2, BK, NPY, TNF-α, IL-6 and IL-10 levels of four groups of children were significantly higher than those before operation while serum SOD and CAT levels as well as peripheral blood CD3+, CD4+ and CD8+T cell levels were significantly lower than those before operation;serum Cor, NE, MDA, SP, PGE2, BK, NPY, TNF-α, IL-6 and IL-10 levels of N group, R group and N+R group were significantly lower than those of control group while serum SOD and CAT levels as well as peripheral blood CD3+, CD4+ and CD8+T cell levels were significantly higher than those of control group;serum Cor, NE, MDA, SP, PGE2, BK, NPY, TNF-α, IL-6 and IL-10 levels of N+R group were significantly lower than those of N group and R group while serum SOD and CAT levels as well as peripheral blood CD3+, CD4+ and CD8+T cell levels were significantly higher than those of N group and R group. Conclusion: Nalbuphine preemptive analgesia combined with ropivacaine local infiltration can reduce the postoperative incision pain and stress response and improve the immune function in children.展开更多
Background:Nalbuphine has been suggested to be used for post-cesarean section(CS)intravenous analgesia.However,ideal concentration of nalbuphine for such analgesia remains unclear.The present study was conducted to ex...Background:Nalbuphine has been suggested to be used for post-cesarean section(CS)intravenous analgesia.However,ideal concentration of nalbuphine for such analgesia remains unclear.The present study was conducted to explore an ideal concentration of nalbuphine for post-CS intravenous analgesia by evaluating the analgesic effects and side-effects of three different concentrations of nalbuphine combined with hydromorphone for post-CS intravenous analgesia in healthy parturients.Methods:One-hundred-and-fourteen parturients undergoing elective CS were randomly allocated to one of three groups(38 subjects per group)according to an Excel-generated random number sheet to receive hydromorphone 0.05 mg/mL+nalbuphine 0.5 mg/mL(group LN),hydromorphone 0.05 mg/mL+nalbuphine 0.7 mg/mL(group MN),and hydromorphone 0.05 mg/mL+nalbuphine 0.9 mg/mL(group HN)using patient-controlled analgesia(PCA)pump.Visual analog scale(VAS)for pain,PCA bolus demands,cumulative PCA dose,satisfaction score,Ramsay score,and side-effects such as urinary retention were recorded.Results:The number of PCA bolus demands and cumulative PCA dose during the first 48 h after CS were significantly higher in group LN(21±16 bolus,129±25 mL)than those in group MN(15±10 bolus,120±16 mL)(both P<0.05)and group HN(13±9 bolus,117±13 mL)(both P<0.01),but no difference was found between group HN and group MN(both P>0.05).VAS scores were significantly lower in group HN than those in group MN and group LN for uterine cramping pain at rest and after breast-feeding within 12 h after CS(all P<0.01)and VAS scores were significantly higher in group LN than those in groupMNand group HN when oxytocin was intravenously infused within 3 days after CS(all P<0.05),whereas VAS scores were not statistically different among groups for incisional pain(all P>0.05).Ramsay sedation scale score in groupHNwas significantly higher than that in group MN at 8 and 12 h after CS(all P<0.01)and group LN at 4,8,12,24 h after CS(all P<0.05).Conclusions:Hydromorphone 0.05 mg/mL+nalbuphine 0.7 mg/mL for intravenous PCA could effectively improve the incisional pain and uterine cramping pain management and improve comfort in patients after CS.展开更多
文摘BACKGROUND Gastric cancer(GC)is a prevalent tumor in the digestive system,with around one million new cases reported annually,ranking it as the third most common malignancy.Reducing pain is a key research focus.This study evaluates the effect of nalbuphine on the analgesic effect and the expression of pain factors in patients after radical resection.AIM To provide a reference for postoperative analgesia methods.METHODS One hundred eight patients with GC,admitted between January 2022 and June 2024,underwent radical gastrectomy.They received a controlled analgesia pump and a transverse abdominis muscle plane block,divided into two groups of 54 patients in each group.The control group received sufentanil,while the observation group received nalbuphine as an analgesic.Postoperative analgesic effects,pain factor expression,and adverse effects were compared.RESULTS The resting pain and activity pain scores in the observation group at 6,12,24 and 48 hours were significantly lower than those in the control group.Additionally,the number of presses and consumption of the observation group at 48 hours were lower than those of the control group;and the response rate of the observation group was higher than that of the control group(P<0.05).The prostaglandin E2,substance P,and serotonin levels 24 hours after the observation group were lower than those in the control group,and the incidence of adverse reactions was 5.56%lower than 22.22%in the control group(P<0.05).CONCLUSION The findings suggest that nalbuphine enhances postoperative multimodal analgesia in patients with radical GC,effectively improving postoperative analgesic effect,relieving postoperative resting and active pain,and reducing postoperative pain factor expression,demonstrating its potential for clinical application.
基金Supported by National Natural Science Foundation of China,No.82404612.
文摘This editorial highlights the randomized controlled trial by Qian et al evaluating the efficacy of nalbuphine in managing postoperative pain and associated inflammatory factors in patients undergoing radical gastrectomy for gastric cancer.Utilizing a multimodal analgesic approach with a controlled analgesia pump and a transverse abdominis muscle plane block,the study compared nalbuphine against sufentanil.Results indicate that nalbuphine significantly reduces pain scores at various postoperative intervals,decreases consumption and patientcontrolled analgesia presses,and lowers levels of pain markers such as prostaglandin E2,serotonin,and substance P.While both agents demonstrated effective pain control,nalbuphine was associated with a lower incidence of adverse effects,suggesting its potential as a valuable alternative in appropriate clinical scenarios.This study offers valuable insights into nalbuphine’s clinical applicability,underscoring its benefits for pain management and enhancing patient recovery in the postoperative setting.
文摘BACKGROUND Radical laparoscopic gastrectomy is an important treatment modality for gastric cancer.Surgery requires general anesthesia,and patients are susceptible to the effects of anesthetic drugs and carbon dioxide insufflation during the procedure,leading to inflammation or severe pain,which can affect patient outcome.AIM To explore the efficacy of combining dexmedetomidine(DEX)with nalbuphine in patients underwent laparoscopic radical gastrectomy for gastric cancer.METHODS Patients scheduled to undergo laparoscopic radical gastrectomy were selected and randomly assigned to A or B group.In A group,patients received an intravenous injection of nalbuphine 0.2 mg/kg+DEX 0.4μg/kg 10 min before the end of surgery;in B group,patients received only an intravenous injection of nalbuphine.The trends in hemodynamic parameter fluctuations,awakening quality during the recovery period,serum inflammatory markers,agitation scores,cough severity,incidence,and duration of postoperative delirium(POD)were compared.RESULTS The mean arterial pressure and heart rate in the A group were more stable(P<0.05).The A group had a lower average awakening time,extubation time,and agitation scores during recovery than the B group.Agitation control in the A group was more effective at different time points(P<0.05).Patients in the A group had lower serum interleukin(IL)-6,tumour necrosis factor alpha,and IL-10 levels at 1 h after surgery than the B group.The incidence of coughing and duration of POD were lower and shorter in the A group than in the B group.Adverse reactions caused by the two anesthesia methods were less frequent in the A group than in the B group(P<0.05).CONCLUSION The use of DEX and nalbuphine in patients undergoing laparoscopic radical gastrectomy for gastric cancer help reducing the inflammatory response,cough severity,and agitation and helps maintain hemodynamic stability.
文摘Background: Nalbuphine is a derivative of 14-hydroxymorphine which is a strong analgesic with mixed k agonist and μ antagonist. Nalbuphine was studied several times as adjuvant to local anesthetics in spinal, epidural and local intravenous block. The aim of this study was to evaluate the effect of nalbuphine as an adjuvant to local anesthetics in supraclavicular brachial plexus block. Patients and Methods: Fifty-six patients undergoing elective forearm and hand surgery under supraclavicular brachial plexus block were allocated randomly into one of two groups of 28 patients each to receive either 25 ml (0.5%) bupivacaine with 1 ml of NS or 25 ml (0.5%) bupivacaine with 1 ml (20 mg) nalbuphine. Onset time and duration of both sensory and motor block, and post-operative analgesia were observed. Result: Nalbuphine group showed significant increase in the duration of motor block (412.59 ± 18.63), when compared to control group (353.70 ± 29.019) p-value < 0.001, also, there was significant increase in sensory duration in nalbuphine group (718.14 ± 21.04) when compared to control group (610.18 ± 26.33) p-value < 0.001, without affecting the onset time of the blockade. And also, there was a significant increase in the duration of analgesic effect in nalbuphine group (835.18 ± 42.45) when compared to control group (708.14 ± 54.57) p-value < 0.001. Conclusion: The present study demonstrates that addition of 20 mg nalbuphine to bupivacaine in supraclavicular brachial plexus block is associated with significant increase in the duration of both sensory and motor block and also prolong the duration of analgesia.
文摘Opioids are drugs used to alleviate pain. However, studies have demonstrated that these drugs can cause an increase in pain sensitivity, which is called opioid-induced hyperalgesia. The objective of this study was to describe the effects of dexamethasone, clonidine, tramadol and nalbuphine on fentanyl-induced hyperalgesia in rats. After obtaining approval from the Committee for the Ethical Use of Animals (CEUA), 36 male Wistar rats were divided into 6 groups: Group 1 (GCSSL) wherein the rats received 1 ml 0.9% saline solution in two injections;Group 2 (GFTSL), received fentanyl at a dose of 100 ug<span style="white-space:nowrap;">·</span>kg<sup>-1</sup> followed by 1 ml 0.9% saline solution via intraperitoneal;the remaining groups (3, 4, 5, 6) received fentanyl at a dose of 100 ug<span style="white-space:nowrap;">·</span>kg<sup>-1</sup> following doses via intraperitoneal: Group 3 (GFTDX), dexamethasone at a dose of 1.0 mg<span style="white-space:nowrap;">·</span>kg<sup>-1</sup>;Group 4 (GFTCL), clonidine at a dose of 20 mg<span style="white-space:nowrap;">·</span>kg<sup>-1</sup>;Group 5 (GFTTR), tramadol at a dose of 50 mg<span style="white-space:nowrap;">·</span>kg<sup>-1</sup>, and Group 6 (GFTNB), nalbuphine at a dose of 5 mg<span style="white-space:nowrap;">·</span>kg<sup>-1</sup>. Under general anestesia using isoflurane, the animals were submitted to a surgical incision. Hyperalgesia was evaluated by applying Von Frey filaments at 2 hours after the incision and on the 1<sup>st</sup>, 3<sup>rd</sup> and 5<sup>th</sup> days afterward. At 2 hours after the surgical procedure, there was lower intensity of pain in the fentanyl group (GFTSL) compared to the other groups, and on the fifth day there were no significant differences for pain intensity between groups. The results suggest the presence of fentanyl-induced hyperalgesia and efficacy in its reduction by dexamethasone, clonidine, tramadol and nalbuphine.
文摘Intravenous Regional Anesthesia (IVRA) is easy to administer and reliable. But delayed onset and lack of postoperative analgesia are the major limitations. Accordingly, many additives have been tried. Dexmedetomidine is a highly selective α-2 adrenoceptor agonist. Addition of dexmedetomidine to lignocaine is effective in decreasing the anesthetic requirements and prolonging the analgesic duration. On the other hand, many theories explain that opioids may exert their peripheral action through peripheral opioid receptors. The aim of the study was to compare the analgesic efficacy of nalbuphine and dexmedetomidine when used separately as adjuvants to lidocaine during IVRA with the effect of lidocaine alone. Sixty adult patients, who were scheduled for surgery of the hand or the forearm under intravenous regional anesthesia, were included in this study. The patients were randomly allocated into three equal groups. The syringes in all groups contained 3 mg/kg of lidocaine 0.5% diluted in 40 ml isotonic saline. Group C: Control group. Group D: Dexmedetomidine group, 1 mic/kg dexmedetomidine diluted was added. Group N: Nalbuphine group, 20 mg nalbuphine was added. Sensory onset time (min) as well as motor block onset time (min) were significantly shorter in Groups N (2.0 ± 1.7) (3.8 ± 2.1) respectively, and D (2.2 ± 1.8) (4.6 ± 2.2) respectively compared to Group C (3.6 ± 1.6) (7.1 ± 1.4) (P < 0.05), with no significant differences between nalbuphine and dexmedetomidine groups. Sensory and motor block recovery times (min) were significantly longer in Groups N (9.6 ± 0.7) (10.3 ± 1.2) and D (8.1 ± 1.1) (9.1 ± 2.1) when compared to Group C (3.4 ± 2.1) (3.7 ± 3.1) (P < 0.05), without significant differences between nalbuphine and dexmedetomidine. Ramsay sedation score was significantly higher (RSS = 2) in 14 patients (70%) in Group D compared to Groups C and N during the first 30 min after the release of tourniquet.
文摘Objective: To study the effect of nalbuphine preemptive analgesia combined with ropivacaine local infiltration on postoperative incision pain, stress response and immune function in children. Methods: Children who received selective laparotomy in Mianyang Central Hospital between August 2015 and August 2017 were selected and randomly divided into control group, nalbuphine group (N group), ropivacaine group (R group) and nalbuphine + ropivacaine group (N+R group). The levels of pain and stress-related mediators in serum and the levels of immune cells in peripheral blood were detected before operation and 24 h after operation. Results: 24 h after operation, serum Cor, NE, MDA, SP, PGE2, BK, NPY, TNF-α, IL-6 and IL-10 levels of four groups of children were significantly higher than those before operation while serum SOD and CAT levels as well as peripheral blood CD3+, CD4+ and CD8+T cell levels were significantly lower than those before operation;serum Cor, NE, MDA, SP, PGE2, BK, NPY, TNF-α, IL-6 and IL-10 levels of N group, R group and N+R group were significantly lower than those of control group while serum SOD and CAT levels as well as peripheral blood CD3+, CD4+ and CD8+T cell levels were significantly higher than those of control group;serum Cor, NE, MDA, SP, PGE2, BK, NPY, TNF-α, IL-6 and IL-10 levels of N+R group were significantly lower than those of N group and R group while serum SOD and CAT levels as well as peripheral blood CD3+, CD4+ and CD8+T cell levels were significantly higher than those of N group and R group. Conclusion: Nalbuphine preemptive analgesia combined with ropivacaine local infiltration can reduce the postoperative incision pain and stress response and improve the immune function in children.
基金supported by the grant from National Natural Science Foundation of China(No.81471126).
文摘Background:Nalbuphine has been suggested to be used for post-cesarean section(CS)intravenous analgesia.However,ideal concentration of nalbuphine for such analgesia remains unclear.The present study was conducted to explore an ideal concentration of nalbuphine for post-CS intravenous analgesia by evaluating the analgesic effects and side-effects of three different concentrations of nalbuphine combined with hydromorphone for post-CS intravenous analgesia in healthy parturients.Methods:One-hundred-and-fourteen parturients undergoing elective CS were randomly allocated to one of three groups(38 subjects per group)according to an Excel-generated random number sheet to receive hydromorphone 0.05 mg/mL+nalbuphine 0.5 mg/mL(group LN),hydromorphone 0.05 mg/mL+nalbuphine 0.7 mg/mL(group MN),and hydromorphone 0.05 mg/mL+nalbuphine 0.9 mg/mL(group HN)using patient-controlled analgesia(PCA)pump.Visual analog scale(VAS)for pain,PCA bolus demands,cumulative PCA dose,satisfaction score,Ramsay score,and side-effects such as urinary retention were recorded.Results:The number of PCA bolus demands and cumulative PCA dose during the first 48 h after CS were significantly higher in group LN(21±16 bolus,129±25 mL)than those in group MN(15±10 bolus,120±16 mL)(both P<0.05)and group HN(13±9 bolus,117±13 mL)(both P<0.01),but no difference was found between group HN and group MN(both P>0.05).VAS scores were significantly lower in group HN than those in group MN and group LN for uterine cramping pain at rest and after breast-feeding within 12 h after CS(all P<0.01)and VAS scores were significantly higher in group LN than those in groupMNand group HN when oxytocin was intravenously infused within 3 days after CS(all P<0.05),whereas VAS scores were not statistically different among groups for incisional pain(all P>0.05).Ramsay sedation scale score in groupHNwas significantly higher than that in group MN at 8 and 12 h after CS(all P<0.01)and group LN at 4,8,12,24 h after CS(all P<0.05).Conclusions:Hydromorphone 0.05 mg/mL+nalbuphine 0.7 mg/mL for intravenous PCA could effectively improve the incisional pain and uterine cramping pain management and improve comfort in patients after CS.
