Effects of Nalbuphine combined with Sufentanil on postoperative analgesia and stress response in patients undergoing laparoscopic colorectal cancer surgery
- VernacularTitle:纳布啡联合舒芬太尼对腹腔镜结直肠癌手术患者术后镇痛效果及应激反应的影响
- Author:
Yun YAN
1
;
Li XU
;
Mingquan YANG
Author Information
- Keywords: laparoscopy; colorectal cancer; Nalbuphine; Sufentanil; postoperative analgesia; stress response
- From: China Journal of Endoscopy 2024;30(2):33-40
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the impacts of Nalbuphine combined with Sufentanil on postoperative analgesia and stress response in patients undergoing laparoscopic colorectal cancer surgery.Methods 86 patients who underwent laparoscopic colorectal cancer surgery from August 2020 to April 2022 were collected and grouped into an experimental group and a control group according to the analgesic plan,with 43 patients in each group.The control group was given Sufentanil after surgery,and the experimental group was given Nalbuphine + Sufentanil.The analgesic and sedative effects at different time points after surgery(1,6,12,24 and 48 h),and the changes in serum pain mediator and stress response indicators were observed and compared.The time of getting out of bed after surgery,the number of patient-controlled analgesia,the number of cases of remedial analgesia,the recovery of gastrointestinal function,and the occurrence of adverse reactions within 48 hours after surgery were recorded in both groups.Results Compared with the control group,the experimental group had a shorter time to get out of bed for the first time after surgery(t = 3.29,P = 0.001),and had fewer instances of patient-controlled analgesia(Z = 4.53,P = 0.000)and cases of remedial analgesia(χ2 = 4.48,P = 0.034);Postoperative 12,24 and 48 h after surgery,the visual analogue scale(VAS)in the experimental group was obviously lower than that in the control group(t = 2.86,t = 2.55,t = 0.10,P<0.05);Postoperative 1 and 6 h,the Ramsay sedation score in the experimental group patients was lower than that in the control group(t = 2.10,t = 2.07,P<0.05);Postoperative 6,12 and 24 h,the serum substance P(SP)(t = 3.63,t = 5.51,t = 3.46,P<0.05)and prostaglandin E2(PGE2)(t = 2.34,t = 3.56,t = 0.33,P<0.05)levels in the experimental group were obviously lower than those in the control group;Postoperative 6,12 and 24 h,the serum cortisol(Cor)level in the experimental group was obviously lower than that in the control group(t = 4.65,t = 6.50,t = 6.52,P<0.05);Postoperative 6,12,24 and 48 h,the serum norepinephrine(NE)(t = 5.49,t = 7.85,t = 7.70,t = 2.18,P<0.05),tumor necrosis factor-α(TNF-α)(t = 5.43,t = 7.83,t = 5.27,t = 2.32,P<0.05),and hypersensitivity C-reactive protein(hs-CRP)(t = 3.39,t = 9.241,t = 4.87,t = 2.37,P<0.05)levels in the experimental group were obviously lower than those in the control group.There was no statistically obvious difference between the two groups in terms of postoperative exhaust time,defecation time,bowel sounds occurrence time,and incidence of adverse reactions(P>0.05).Conclusion Nalbuphine combined with Sufentanil is effective in postoperative analgesia of laparoscopic colorectal cancer patients,and can effectively regulate the post-traumatic stress response of the body after surgery.
