| Background:In recent years,the concept of rapid postoperative rehabilitation(ERAS)has developed rapidly and has been widely used in various fields of surgery,and has made great achievements in theory and practice.The application and implementation of the ERAS concept has significantly improved the effect of treatment,reduced postoperative complications,accelerated the recovery of patients,greatly shortened the length of hospitalization,reduced overall medical expenses,and reduced the burden on society and families.The application of multimodal analgesia in postoperative pain management is an important part of ERAS.With the development of the concept of ERAS,multimodal analgesia techniques have gradually been widely used.Postoperative pain is a public health problem.Although it has attracted more and more attention,there are relatively few methods available to prevent or reduce this postoperative complication.Objective:To investigate the analgesic effect,application plan and safety of nalbuphine combined with parisibuna for injection after laparoscopic hepatectomy.Method:1.Select the patients who were admitted to the Department of Hepatobiliary Surgery in Jingzhou Central Hospital from March 2020 to February 2021 and plan to undergo laparoscopic liver resection as the research subjects,communicate with the patients in detail before surgery,obtain their consent,participate in the study voluntarily,and sign informed consent book.2.Adopt the principle of randomization to divide the patients into nalbuphine group,special resistance group and combination medication group.Observe and record the visual analog pain score(VAS)of patients at 6h,12 h,24h,48 h after operation;Cortisol,IL-6,C-reactive protein(CRP),procalcitonin(PCT)levels on the 1st,3rd and5 th days later;the earliest time for gastrointestinal function to recover and get out of bed;adverse reactions such as nausea and vomiting Case.3.Perform statistical analysis on all the above-collected data,and compare the differences in the postoperative VAS scores,various inflammatory indexes,gastrointestinal recovery time and earliest time to go to the ground among different groups of patients.4.The statistical analysis of all data is processed by SPSS22.0,and the two-tailed P value is less than 0.05 is considered to be statistically different.Result:In the end,60 patients completed the experiment,20 in each group.At 6 hours and 12 hours after operation,the VAS scores of the three groups were significantly different,which was statistically significant(P<0.05).The specific resistance group was 6.20±1.54,3.55±0.83,the nalbuphine group was 5.11±1.17,3.25±1.16,and the combination group was 4.40±1.00,2.60±0.88.There was no significant difference in VAS scores between the three groups at 24 hours and 48 hours after surgery(P>0.05).The levels of cortisol,CRP,PCT,and IL-6 in the three groups all showed a trend of rising first and then falling.The increase in the special resistance group was the largest,followed by nalbuphine,and the lowest in the combination group.There were statistically significant differences in the gastrointestinal function recovery time and the earliest time to get out of bed in the three groups of patients(P<0.05).There was no significant difference in the occurrence of nausea and vomiting among the three groups of patients(P>0.05).In conclusion:The analgesic effect of nalbuphine after laparoscopic hepatectomy is definite.Its control effect on severe pain is stronger than that of special resistance.The analgesic effect of the combined drug group was better than that of a single drug.For mild to moderate pain,there is no significant difference in the analgesic effect of the two drugs.Nalbuphine can reduce the intensity of the postoperative stress reaction of the patient,promote the recovery of gastrointestinal function,and accelerate the recovery of the patient. |
PDF Full Text Request