Analgesic Effect Evaluation Of Nalbuphine In Postoperative Analgesia On Children Undergoing Remifentanil-based Anaesthesia

Objectives:To observe the analgesia effect and the occurrence of side-effects of nalbuphine on children undergoing remifentanil-based anaesthesia.Methods:102 patients scheduled for radical operation for tonsillectomy(or combined adenoidectomy)undergoing general anesthesia,64 males and 38 fe-males,aged 3?7 years,ASA physical status ? or ?,were randomly divided into 3 groups:sufentanil group(group S)?nalbuphine group(group N)?control group(group D),34 patients each group.sufentanil 0.1 ug/kg was administered intravenously in group S and D while nalbuphine 0.15mg/kg was injected in group N the end of operation.Postoperative analgesia was provided by PCA pumb(100ml)with CNI+PCA model(load dosage 2ml+lasting dosage 2ml+ Self-control dosage 2ml/per time)of group S and N.Group D don't use PCA pumb.Group S,sufentanil2.0ug/kg +ondansetron 0.2mg/kg+ normal saline to 100 ml;group N,nalbuphine2mg/kg +ondansetron 0.2mg/kg+ normal saline to 100 ml.Observation of CHEOPS score at 10min(T0)?30min(T1)?2h(T2)?4h(T3)?8h(T4)?12h(T5)18h(T6)?24h(T7)and Ramsay sedation score at 2h(T2)?4h(T3)?8h(T4)?12h(T5)immediately after extubation.Extubation time and residence time of PACU were recorded and the incidence of PONV?Respiratory depression?itching?fever and bleeding 24h after extubation were recorded.Results:Pairwise comparison between groups S and N found no significant differences in CHEOPS score at T0?T7(P>0.05).The CHEOPS scores in group D were significantly higher than those in group S at T2?T5(P<0.05)and no significant differences between groups S and D at T0?T2?T6?T7(P>0.05).The CHEOPS scores in group D were significantly higher than those in group N at T2?T4(P<0.05)and no significant differences between groups N and D at T0?T1?T5?T7(P>0.05).The Ramsay scores in group N were significantly higher than those in group S at T3?T5(P<0.05)and no significant differences between groups N and S at T2(P>0.05).The Ramsay scores in group S were significantly higher than those in group D at T2-T4(P<0.05)and no significant differences between groups D and S at T5(P>0.05).The Ramsay scores in group N were significantly higher than those in group D at T2?T5(P<0.05).There was no significant differences of residence time of PACU and extubation time between groups S and D(P>0.05),but were significantly higher than those in group N(P<0.05).Adverse reactions of three groups were similar.Conclusions:The analgesia effect nalbuphine on children undergoing remifentanil-based anaesthesia is good,but slightly weaker than sufentanil.Nalbuphine can shorten extubation time and residence time of PACU and it's respiratory depression is mild.Nalbuphine has a calming effect and It's other adverse reactions is similar with sufentanil.