Clinical Effect Of Nalbuphine Combined With Flurbiprofen For Postoperative Analgesia By PCIA After Cesarean Section

Objective:To investigate the clinical effect of nalbuphine combined with flurbiprofen for postoperative analgesia by PCIA after cesarean section.Methods:120 ASA I or II primipara with term pregnancy,aged 20³5yr,weighing 155¹73 cm,from January 2017 to January 2018,scheduled for elective cesarean section were divided into 2 groups（n=60）:nalbuphine combined with flurbiprofen group（group N）and sufentanil combined with flurbiprofen group（group S）using a random number table.Before the operation,all patients fasted and received combined spinal and epidural analgesia.The vital signs including SBP,DBP,HR,ECG,and SpO₂ were monitored.After fetal delivery,patient-controlled intravenous analgesia（PCIA）（100 ml）with nalbuphine 1.0mg/kg combined with flurbiprofen 3mg/kg or sufentanil 1μg/kg combined with flurbiprofen 3mg/kg was used for postoperative analgesia.The PCIA pump was set up with a 0.5 ml bolus dose,a 15 min lockout interval and background infusion at a rate of 2 ml/h.The changes of SBP,DBP,HR,and SpO₂,VAS score at rest and during movement and Ramsay sedation score in the two groups at 2,4,6,8,12,24 and 48h after operation were recorded.Patients received massaging of the uterus every 30minutes to promote lochia discharge within 2 hours after operation and VAS score was assessed.The adverse effects such as urinary retention,nausea,vomiting,respiratory depression and pruritus and the level of patients’satisfaction for PCIA were also recorded in the two groups.Results:There was no significant difference in the patients’age,height,weight and gestational weeks between the two groups（P>0.05）.Compared with preoperative vital signs,the SBP and HR at 6 and 12 hour after operation were slightly increased in the two groups（P<0.05）.And there was no significant difference in SBP,DBP,HR and SPO₂ between the two groups（P>0.05）.Compared with group S,the VAS scores during movement at 6,12 and24h after operation in group N was decreased（P<0.05）and there was no significant difference in the VAS scores at rest at different time points（P>0.05）.When received massaging of the uterus,the VAS score of patients in group N was decreased（P<0.05）.Compared with group S,the level of patients’satisfaction was increased in group N（P<0.05）and there was no significant difference in Ramsay sedation score between the two groups（P>0.05）.There was only 1 patient in group S felling nausea.Conclusions:1.Nalbuphine and sufentanil combined with flurbiprofen for postoperat-ive analgesia by PCIA after cesarean section are effective and the adverse effects are less.2.Nalbuphine combined with flurbiprofen for postoperative analgesia during movement is more effective than sufentanil combined with flurb-iprofen.3.Nalbuphine combined with flurbiprofen for pain of uterine contraction after cesarean section is highly effective.