ABSTRACT
Objective:To preliminarily evaluate the effectiveness and safety of nalbuphine for patient-controlled intravenous analgesia (PCIA) after cesarean section.Methods:This study was a single arm clinical trial.Sixty parturients, aged 20-44 yr, weighing 50-80 kg, of American Society of Anesthesiologists physical status ⅠorⅡ, scheduled for cesarean section with epidural anesthesia, were enrolled in this study.PCIA was performed when visual analogue scale (VAS) score for postoperative pain ≥3 points following cesarean section.A bolus of nalbuphine 10 mg was intravenously injected as a loading dose.PCIA pump solution contained 110 mg nalbuphine diluted to 200 ml with normal saline.The pump was set up with a background infusion at a rate of 4 ml/h, 2 ml bolus dose and 15 min lockout interval.The VAS scores for pain at rest and during activity and uterine contraction pain, Ramsay sedation scores and adverse reactions were observed within 48 h after surgery.Results:The VAS scores for pain at rest and during activity and uterine contraction pain were all ≤3 points, the Ramsay scores were maintained at 2-4 points, hemodynamic parameters were maintained in the normal range, and no adverse reactions such as nausea and vomiting, drowsiness, hyperhidrosis, dizziness, pruritus, and respiratory depression occurred.Conclusion:PCIA with nalbuphine given according to the method mentioned above has good feasibility when used for analgesia following cesarean section.
ABSTRACT
Objective To compare the accuracy of bispectral index (BIS),Narcotrend index (NI),index of consciousness (IoC) versus auditory evoked potential index (AAI) in monitoring the depth of sedation induced by propofol.Methods Sixty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 41-64 yr,with body mass index 20-30 kg/m2,scheduled for elective surgeries under general anesthesia,were enrolled in the study.Propofol was given by target-controlled infusion (TCI) with the initial target effect-site concentration (Ce) of 0.8 μg/ml using Marsh pharmacokinetic model,and then the Ce of propofol was increased by 0.1 μg/ml,and OAA/S was performed.Before TCI of propofol,the values of BIS,NI,IoC and AAI were recorded,and at the same time the value of OAA/S score was 5.During TCI of propofol,when OAA/S score reached 4,3,2 and 1 in turn,the Ce of propofol was recorded,the sequence for determination of the values of BIS,NI,IoC and AAI was determined using a random number table,and the values were then recorded for 5 s after the values were stable and then averaged.The parameters for vital signs were maintained within the normal range.Pearson correlation of BIS,NI,IoC and AAI values with Ce of propofol was analyzed.Results The correlation coefficients of BIS,NI,IoC and AAI values with the Ce of propofol were rBIs-Ce =-0.829,rSI-Ce =-0.886,rloC-Ce =-0.881 and rAAI-Ce =-0.791,respectively.There was no significant difference between rBIS-Ce,rNI-Ce,rIoC-Ce and rAAI-Ce.Conclusion There are no significant differences in the accuracy of BIS,NI,IoC or AAI in monitoring the depth of sedation induced by propofol in middle-aged patients with non-noxious stimuli.