不同κ受体激动剂在日间腹腔镜胆囊切除术中的镇痛作用

不同κ受体激动剂在日间腹腔镜胆囊切除术中的镇痛作用

贵州医科大学     麻醉与心脏电生理课题组

翻译：邓举  编辑：张中伟  审核：曹莹

摘 要

背景：比较两种不同的κ受体激动剂，纳布啡和羟考酮，以及常规吗啡对日间腹腔镜胆囊切除术后急性疼痛预防性镇痛的效果。

方法：124例接受腹腔镜胆囊切除术的患者被随机分配到纳布啡（N组）、羟考酮（O组）和吗啡（M组）。三组均在切皮前静脉注射（iv）0.15mg/kg,气腹结束时注射0.05mg/kg。记录术后1、2、4、8、12、16、20和24小时的视觉模拟量表(VAS)评分（切口、内脏和肩膀）和Ramsay镇静评分，拔管时间、术后不良事件发生率、疼痛治疗满意度、术后住院时间。

结果：与M组相比，N组和O组在术后1-8h，静息时内脏疼痛的VAS评分均有所下降(P<0.05）。N组运动时内脏疼痛的VAS评分较O组下降的时间更长(P<0.05）。与M组相比，O组术后Ramsay镇静评分的增加时间长于N组(P<0.05）。与N组相比，O组患者睡眠质量较差，M组患者住院时间延长，两组患者满意度均较低。

结论：与吗啡相比，在腹腔镜胆囊切除术中预防性使用κ受体激动剂纳布啡和羟考酮可减少术后内脏疼痛。此外，纳布啡组的不良反应较少，镇痛效果较好，满意度较好。

原始文献来源：Wanjun Zhou, Jiawu Wang,Chengyun Hu,et al. Analgesic Effects of Different κ-Receptor Agonists Used in Daytime Laparoscopic Cholecystectomy. [J]BioMed Research International Volume 2021, Article ID 2396008, 8 pages.

英文原文   

Analgesic Effects of Different κ-Receptor Agonists Used in Daytime Laparoscopic Cholecystectomy

Abstract

Background:Comparing the effffect of two difffferent κ-receptor agonists, nalbuphine and oxycodone, and regular morphine in patients for prophylactic analgesia of acute pain after daytime laparoscopic cholecystectomy.

Method:One hundred and twenty-four patients undergoing laparoscopic cholecystectomy were randomly allocated to receive nalbuphine (group N),oxycodone (group O), and morphine (group M). The three groups were all given intravenous injection (iv.) of 0.15 mg/kg injection before incision and 0.05 mg/kg injection at the end of pneumoperitoneum. The Visual Analogue Scale (VAS) scores (incision, visceral, and shoulder) and Ramsay sedation scores at 1, 2, 4, 8, 12, 16, 20, and 24 hours after surgery, the time of extubation, the incidence of postoperative adverse events, the satisfaction of pain treatment, and the duration of stay after surgery were all recorded.

Results:Compared with group M, the VAS scores of visceral pain at rest decreased in group N and group O at 1-8 h after surgery (P < 0:05). The VAS scores of visceral pain at movement in group N decreased longer than those in group O (P < 0:05). Compared with that of group M, the postoperative time in Ramsay sedation score of group O increased longer than that of group N (P < 0:05). Compared with group N, patients had worse sleep quality in group O, longer length of stay in group M, and lower satisfaction in both groups.

Conclusion:Compared with morphine,prophylactic use of the κ-receptor agonists, nalbuphine and oxycodone, during laparoscopic cholecystectomy can reduce postoperative visceral pain. Furthermore, the nalbuphine group had fewer adverse reactions, better analgesia, and better satisfaction.