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 observe the influence of low-dose dexmedetomidine combined with sufentanil PCIA on post-operative delirium in elderly patients undergoing hip fracture surgery. Methods Sixty elderly patients aged 65~80, ASAⅠorII, undergoing elective hip fracture surgery by combined spinal-epidural anesthesia were randomly allocated to receive dexmedetomidine combined with sufentanil PCIA group (group D, n=30) and sufentanil PCIA group (group S, n=30). The scores of visual analogue scales (VAS) was recorded at 6、12、24 and 48 h after operation, and cognitive function was assessed 1 d preoperatively and on the postoperative 2, 4 and 6 d with MMSE and CAM after PCIA. Re-sults The VAS scores in each time point of two groups after operation were both ≤4, there was no significantly differ-ence in the pain score between two groups, in group D, times of press analgesia device was less than that in group S (P<0.01); The MMSE score in D group was higher than that in S group on the postoperative 2, 4 and 6 d (P<0.05) and the incidence of postoperative delirium in group D (n=2) was lower than group S(n=8) (6.7% vs 26.7%)(P<0.05). The patients in the two groups had no respiratory suppression. Conclusion Low-dose dexmedetomidine combined with sufentanil PCIA in elderly patients undergoing hip fracture surgery has satisfactory analgesic effect, and can decrease the incidence of postoperative delirium.
