Clinical trial of bupivacaine combined with neostigmine for postoperative analgesia in critically ill patients undergoing general anesthesia
10.13699/j.cnki.1001-6821.2024.23.006
- VernacularTitle:布比卡因复合新斯的明用于急危重症患者全麻手术术后镇痛的临床研究
- Author:
Bi-bi CHEN
1
;
Han-dong HUANG
1
;
De-zhi TANG
1
;
Jun-huang CHEN
1
;
Sheng-biao CHEN
1
Author Information
1. 莆田学院附属医院急诊监护室,福建莆田 351100
- Publication Type:Journal Article
- Keywords:
bupivacaine hydrochloride injection;
neostigmine methylsulfate injection;
general anesthesia surgery critically ill patient;
epidural block;
relieve pain
- From:
The Chinese Journal of Clinical Pharmacology
2024;40(23):3395-3399
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the sedative and analgesic effects of bupivacaine hydrochloride injection combined with neostigmine methylsulfate injection in critically ill patients after general anesthesia operation.Methods Acute and critical patients who were to undergo general anesthesia were randomly divided into control group and treatment group.Two groups received general anesthesia combined with epidural block anesthesia.After operation,the control group was continuously pumped 0.75％bupivacaine hydrochloride injection 45 mL through the epidural catheter,the treatment group was given 2 μg·kg-1 neostigmine methylsulfate injection on the basis of continuous pumping of bupivacaine injection through epidural catheter in the control group.Comparing the pain numerical rating scale(NRS)for 12 h,24 h,48 h,and 72 h of postoperative analgesia and the Ramsay sedation scores(Ramsay),hemodynamic index and safety in the two groups.Results Treatment group were enrolled 32 cases,2 cases dropped out,and 30 cases were finally included in the statistical analysis.Control group were enrolled 32 cases,2 cases dropped out,and 30 cases were finally included in the statistical analysis.The 12-hour Ramsay in the control group and the treatment group were(2.62±0.46)and(2.58±0.51)points;the 24-hour Ramsay were(2.32±0.45)and(2.27±0.39)points;the 48-hour Ramsay were(2.12±0.36)and(2.04±0.32)points;and the 72-hour Ramsay were(1.68±0.34)and(1.57±0.29)points,respectively;the 12-hour NRS were(1.64±0.26)and(1.53±0.28)points;the 24-hour NRS were(2.14±0.37)and(2.23±0.34)points;the 48-hour NRS were(2.57±0.39)and(2.44±0.42)points;the 72-hour NRS were(2.89±0.46)and(2.61±0.51)points,respectively.The NRS score at 72 h after operation in the treatment group was significantly lower than that in the control group(P＜0.05).The 12 h heart rate(HR)in the control group and treatment group were(75.90±6.45)and(75.42±6.24)time·min-1;24 h HR were(76.37±6.28)and(76.43±5.34)times·min-1,48 h HR(78.57±5.14)and(76.95±5.27)time·min-1;72 h HR were(76.49±4.41)and(78.17±4.64)time·min-1,respectively.The 12 h mean arterial pressure(MAP)in the control group and treatment group were(94.34±7.86)and(95.24±7.45)mmHg;24 h MAP were(95.71±7.55)and(96.56±7.29)mmHg;48 h MAP were(96.58±7.36)and(97.64±7.69)mmHg;72 h MAP were(97.63±8.15)and(96.77±8.53)mmHg,respectively the differences of the above indexes between the control group and the treatment group were not statistically significant(all P＞0.05).The extubation time of control group and treatment group were(63.42±16.34)and(59.56±17.27)h,respectively,with no statistical significance(P＞0.05).The adverse drug reactions of two groups were nausea and vomiting,use of rescue analgesics 12 h after surgery,and wound infection.The incidences of postoperative adverse drug reactions in the control group and the treatment group were 26.67％and 23.33％,respectively,with no statistical significance(P＞0.05).Conclusion Bupivacaine hydrochloride injection combined with neostigmine methylsulforte injection can significantly enhance the epidural analgesia effect in acute and critical patients undergoing general anesthesia,and the safety is better.
