Effects Of Different Dose Of Nalbuphine Combined With Propofol On Transvaginal Oocyte Retrival

Backgroud The concept of ambulatory surgery was first proposed by British pediatric surgeon Nicho.Until 1970,the first day operation center was set up in the United States.Today,ambulatory surgery has developed into a mature surgical management model.This type of surgical management is was developed rapidly in recent years due to its large population and relatively scarce medical resources.In order to satisfy the demand of ambulatory surgery,the anesthetics with quickly effect and recover,and residual less are mostly used[1].Currently,propofol has become the main intravenous anesthetic for day operation.But propofol can not keep the patients under enough in analgesia.We need to usetraditional opioid drugs such as fentanyl,sufentanil at the same time.And monitor the patient's respiratory rateclosely in order to prevent hypoxemia.Nalbuphine,as a kind of excited-antagonism drugs[2],it has a big analgesic activity and hemodynamic stability,but no obvious respiratory deression and addiction[3].There is no clearly report that whether nalbuphine can effectively used on transvaginal oocyte retrival by puncture or not.In this study,we chosesome patients who scheduled for electivetransvaginal oocyte retrival under ultrasonography for test.And compare the different doses of nalbuphine on transvaginal oocyte retrival by puncture,its effect on hemodynamic and respiratory.After the operation,we observe the incidence of postoperative adverse reactions such as nausea and vomiting,so as to provide reference for clinical.Objective To compare the efficacy and safety of different doses of nalbuphine and propofol ontransvaginal oocyte retrival by punctureMethods Two hundred patients,aged 23-45 yr,of American Society of Anesthesiologists physical status ?or ?,scheduled for electivetransvaginal oocyte retrival under transvaginal ultrasonography in our hospital,were randomly divided into four groups(n=50): control group(group C),sufentanil group(group S),nalbuphine group1(group N1),and nalbuphine group2(group N2),using a random number table.At 10 mins before surgery,nalbuphine 0.1mg/kg was injected in intravenously in group N1 and 0.2mg/kg in group N2,and sufentanil 0.1ug/kg was injected in intravenously in group S,while the volume of normal saline was given in group C.2mg/kg propofol and 4.48 mg tropisetronwas used in four groups.When it is necessary,we increase the amount of propofol 0.5mg/kg each time.The changes of HR,MAP,RR and SPO2 was recorded,we compared the amount of propofol,operation time,body movement and respiratory depression in the four groups.And the occurrence of somnolence,dizziness,nausea,vomiting and the numerical rating scale(NRS)were followed.Results 1.There was no significant difference in MAP and HR in four groups(P >0.05).Compared with group C,the SPO2 and RR of group S and N2 group was significantly decreased at T3 and T4(P<0.05),and not in the remaining time(P >0 0.05).2.Compare with group C,the amount of propofol,the body movement and the rate of suspended operationwere significantly decreased(P<0.05)in the other three groups.3.There was no significant difference in Ramsay score between the four groups(P >0.05).Compared with group C,the NRS was lower in group S,group N1 and group N2(P<0.05)at T8,T9 and 6 hour after operation.Compared with group S,the NRS of group N1 and group N2 was lower at T9 and 6 hour after operation(P<0.05).The rate of postoperative activity was significantly decreased in group C and group S(P<0.05).Compared with group C,the incidence of dizziness at T8,somnolence?dizziness and nausea at T9,and dizziness,nausea and vomiting at 6 hours after surgery was increased significantly in group N1(P < 0.05).Compared with group C,the incidence of dizziness,somnolence and nausea at T8 and T9,the incidence of vomiting at 6 hours after surgery was increased significantly in group N2(P < 0.05).Compared with group S,the incidence of somnolence at T8 was increased significantly in group C was increased significantly(P < 0.05);the incidence of somnolence and dizziness at T8 and T9 was increased significantly in group N1(P < 0.05).Compared with group S,the incidence of somnolence ?dizziness and nausea at T8 and T9,the incidence of vomiting at 6 hours after surgery was increased significantly in group N2(P < 0.05).Compared with group N1,the incidence of dizziness at T8 and T9,nausea and vomiting at 6 hours after surgery was increased significantly in group N2(P < 0.05).Conclusions Nabulphine combined with propofol can be used in the tranvaginal oocyte retrival under general anesthesia.Nabulphine can reduce the amount of propofol and body movement,and do not affect in awakening.We consider 0.1 mg/kg of nalbuphine to be a recommended dose.The incidence of dizziness,somnolence,nausea and vomiting may increased while using a large doses.