Chen Zheng,Fu Chujie,Peng Tuochao,et al.Analgesia of nabulphine hydrochloride after closed reduction and Kirschner wire internal fixation of ulnar and radius fractures in children[J].Journal of Clinical Pediatric Surgery,2019,18(06):503-507.[doi:10.3969/j.issn.1671-6353.2019.06.013]
盐酸纳布啡用于小儿尺桡骨骨折闭合复位克氏针内固定术后镇痛的临床观察
- Title:
- Analgesia of nabulphine hydrochloride after closed reduction and Kirschner wire internal fixation of ulnar and radius fractures in children
- Keywords:
- Nabuphine; Ulna Fractrues; Radius Fractrues; Analgesia
- 分类号:
- R726.8;R614.2+4;R971+.1
- 摘要:
- 目的 比较盐酸纳布啡和舒芬太尼对小儿尺桡骨骨折闭合复位克氏针内固定术后的镇痛效果及不良反应，探讨盐酸纳布啡用于术后镇痛的安全性和有效性。方法 选取湖南省儿童医院于2017年9月至2018年8月收治的60例尺桡骨骨折需行尺桡骨闭合复位克氏针内固定的患儿为研究对象，依据术后镇痛药物的不同分为盐酸纳布啡组（n=30）和舒芬太尼组（n=30）。比较两组镇痛镇静效果及术后呼吸抑制、恶心呕吐、皮肤瘙痒等不良反应发生率。结果 手术前两组患儿的FLACC评分分别为（1.56±0.32）分和（1.54±0.41）分，差异无统计学意义（t=1.12，P=0.41）；手术后0.5 h、6 h、12 h、24 h两组患儿FLACC评分差异均无统计学意义（P > 0.05）。手术后0.5 h、6 h、12 h、24 h两组患儿Ramsay评分差异均无统计学意义（P > 0.05）。盐酸纳布啡组的术后呼吸抑制、恶心呕吐、皮肤瘙痒等不良反应发生率低于舒芬太尼组，差异均有统计学意义（P < 0.05）。结论 相比于舒芬太尼，盐酸纳布啡更适用于中等疼痛强度手术的术后镇痛。
- Abstract:
- Objective To compare the analgesic efficacies and adverse reactions of nabulphine hydrochloride and sufentanil on children after orthopedic surgery and explore the safety and effectiveness of nabulphine during postoperative analgesia. Methods A total of 60 hospitalized children from September 2017 to August 2018 undergoing Kirschner wire internal fixation plus closed reduction of radius and ulnar bone were selected as study subjects.They were divided into nabulphine hydrochloride group (n=30) and sufentanil group (n=30) according to different anesthetics.The analgesic and sedative effects and the incidence of postoperative respiratory depression,nausea,vomiting and pruritus were evaluated.Results The preoperative FLACC scores of two groups were (1.56±0.32) and (1.54±0.41) respectively.And there was no statistically significant inter-group difference (t=1.12,P=0.41).No statistically significant postoperative difference existed in FLACC scores at 0.5,6,12 and 24 h (P>0.05).No statistically significant inter-group difference existed in postoperative Ramsay scores at 0.5,6,12 and 24 h (P>0.05).The postoperative incidence of respiratory inhibition,nausea,vomiting and pruritus was statistically significant in nabphine hydrochloride group (P<0.05). Conclusion As compared with sufentanil,nalbuphine hydrochloride is more suitable for postoperative analgesia in children undergoing moderately painful surgery.
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备注/Memo
收稿日期:2018-11-08。
基金项目:湖南省科学技术厅临床医疗技术创新引导计划（编号：2018SK50407）
通讯作者:屈双权,Email:qushuangquan1974@163.com