Effects Of Different Dosages Of Intravenous Nalbuphine To Adult Surgery Patients On Cardiac Electrophysiology

Objective:By observing the effects of intravenous injection of different dosages of nalbuphine on QT interval,QTc interval（heart rate corrected QT interval）,Tp-e interval,Tp-e/QT ratio and cardiac electrophysiological balance index（i CEB）,to explore the cardiac electrophysiological stability of nalbuphine and provide a theoretical basis for clinical medication.Methods:A total of 120 adult-patients,aged from 18 to 65 years old,BMI 18.5 to 23.9kg/m²,ASAⅠorⅡ,were selected for elective general anesthesia.The patients were divided into four groups by random number table method:control group（group C）,low-dose group（group L）,medium-dose group（group M）and high-dose group（group H）,with 30patients in each group.After entering the operating room,the venous channels of the left upper limb were opened,oxygen inhalation kept SPO₂above 98%,ECG monitoring was routinely established,and the 12-lead ECG leads were correctly placed on the body surface of the patients.After 15 minutes of silence,the first electrocardiogram（T1 point）was recorded.Group C was intravenously injected with10ml normal saline,group L,group M and group H were intravenously injected with0.1mg/kg,0.2mg/kg and 0.3mg/kg nalbuphine,respectively.The second ECG was recorded 3 minutes later（T2 point）,and the third ECG was recorded 30 minutes later（T3 point）.According to 12-lead ECG and ECG monitor,QT interval,QTc interval,Tp-e interval,Tp-e/QT ratio,cardiac electrophysiological balance index（i CEB）,heart rate（HR）and mean arterial pressure（MAP）were measured or calculated in each group at T1,T2 and T3.QT interval,QTc interval and Tp-e interval were measured at T1,T2and T3,Tp-e/QT ratio and cardiac electrophysiological balance index（i CEB）were calculated,and mean arterial pressure（MAP）and heart rate（HR）at corresponding time points were recorded.Results:Compared with T1,there was no significant difference in HR and MAP in group C,L,M and H at T2（P>0.05）,and there was no significant difference in HR and MAP in group C,L,M and H at T3（P>0.05）,but HR and MAP decreased significantly at T3（P<0.05）;Compared with group C,there was no significant difference in MAP and HR between groups at T1 and T2（P>0.05）,and there was no significant difference in HR and MAP between groups L and m at T3（P>0.05）,but HR and MAP in group H decreased significantly at T3（P<0.05）.At T1,there was no significant difference in QT interval,QTc interval,Tp-e interval,Tp-e/QT ratio and i CEB among the four groups（P>0.05）;Compared with T1,there was no significant difference in QT interval,QTc interval,Tp-e interval,Tp-e/QT ratio and i CEB among the four groups at T2（P>0.05）.Compared with T1,QT interval was prolonged,QTc interval was shortened,Tp-e interval,TP-e/QT ratio and i CEB were increased in L,M and H groups at T3（P<0.05）.Compared with group C,group L,group M and group H prolonged QT interval,shortened QTc interval,decreased Tp-e interval,Tp-e/QT ratio and increased i CEB at T3（P<0.05）.Conclusions:With the increase of dose,nalbuphine can affect the cardiac electrophysiological balance,and the related indexes of cardiac electrophysiology do not have a significant impact,which will not cause the occurrence of malignant arrhythmia.Moreover,within the dose range used in this study,naubuphine can be safely used in clinic.