Evaluation Of The Effect Of Nebuphine Hydrochloride In Elderly Patient Undergoing Percutaneous Transforaminal Endoscopic Discectomy

Objective As an analgesic drug based on?receptor stimulation,nalbufine hydrochloride can effectively reduce side effects such as respiratory depression,nausea and vomiting while providing complete analgesia.The purpose of this study was to investigate the safety and efficacy of nalbufine hydrochloride comparison with sufentanil for intravenous anesthesia in elderly patients undergoing spinal endoscopic surgery.Method:This is a prospective,randomized,double-blind,control study.Sixty-six patients,aged more than 65 years,any gender,body mass index?BMI?of 18.5³0 kg/?,ASA level II^III,undergoing L4-L5vertebral spine endoscopic surgery were randomly assigned to two groups:nalbuphine+midazolam?group N?and sufentanil+midazolam?group S?using a prospective,completely randomized,double-blind design?neither the patient nor the anesthetist knew the drug they were using?.The dosage of midazolam was 0.015mg/kg,nalbuphine was 0.2mg/kg,and sufentanil was 0.2ug/kg.Midazolam was giving after the surgeon checked the patient.Half of the sufentanil or nalbuphine injected after 10min of admission midazolam,and the remaining dose of sufentanil or nalbuphine injected15min later of admission midazolam.The patients'vital signs?blood pressure,heart rate,PetCO2,respiratory frequency,Ramesy score,VAS score?were recorded at 7 time points:before anesthesia?T0?,10min after administration of midazolam?T1?,10min after the first administration of sufentanil or nebuphine?T2?,skin cutting?T3?,grinding of intervertebral foramen?T4?,removing the disc?T5?and the end of surgery?T6?.Intraoperative body motion score was recorded.Adverse respiratory events?apnea,respiratory frequency less than 6 times/min,SPO2<90%,PetCO2>50mmHg?occurred in the intraoperative patients were recorded.After anesthesia,the satisfaction of patients and surgeons was collected and VAS score and adverse events?nausea,vomiting or other discomfort?were recorded at 2h,4h and 24h after surgery.Result:After Intravenous analgesics?T2?the Ramsay score of group N was significantly lower than group S?P<0.05?.The respiratory frequency and oxygen saturation of group S significant decreased at T2 time point?P<0.05?.PetCO₂ and heart rate at T2 were higher in group S than in group N?P<0.05?.The incidence of adverse respiratory events in group N was significantly lower than that in group S?P<0.05?.The incidence of postoperative nausea/vomiting was significantly higher in group S than in group N?P<0.05?.The satisfaction degree of doctor in group S was lower than group N?P<0.05?.There was no significant difference in other indicators?P>0.05?.Conclusion:Nalbuphine combine with midazolam not only ensured the analgesic effect of patients,improved the sedative effect of patients,but also reduced the impact on the respiratory frequency of patients and the incidence of postoperative nausea and vomiting.Therefore,nalbuphine can be safely and effectively applied to intravenous anesthesia in elderly patient undergoing percutaneous transforaminal endoscopic discectomy...