Comparison Of Clinical Effect Between Nalbuphine And Sufentanil For Postoprative Analgesia Of Cesarean Section

Research BackgroundWith the constant development of basic study and clinical trials,the diagnostic assessment method of acute and chronic pain,drug therapy and iatrotechnique are becoming better and approaching perfection gradually.Due to demands of doctors and patients for comfortable medicine in perioperative period,painful treatment is increasingly concerned [1].In 2001,IASP defined pain as unpleasant subjective sensation and emotional experience when humans suffer from noxious stimulation.It was originated from actual or potential tissue damage.Because of pain damage in multiple aspects,the 10 th World Pain Medicine Conference in 2002 has already defined pain as fifth vital signs after body temperature,blood pressure,pulse and breath.Postoperative pain means pain after operation.Under the normal situation,such pain won’t exceed one week and it has a difference from physiological pain.Postoperative pain is caused by changes of postoperative temperature,physical or chemical destroy of body,stimulating body receptors to result in a kind of inflammatory reaction.It belongs to nocuous pain.Postoperative pain takes place a series of responses after completeness of body tissues suffers from damage,including mental,physiological and behavioral responses [2].As a result,to study effective postoperative analgesia not only can alleviate patients’ suffering,but also makes for disease rehabilitation.Meanwhile,it also generates the larger social benefits and economic benefits.Postoperative mentality and physiology of patients with cesarean delivery have some particularity.A set of reasonable and effective analgesia scheme not only can improve postoperative living quality of lying-in women under the guarantee of patient safety,but also won’t cause an undesirable influence on newborn.Clinically,there are a wide range of analgesics for lying-in women after operation and they also have different effects.Good postoperative analgesics can reach the optimal analgesic effects and generate the least side effect.Sufentanil is synthetical opiate receptor stimulant analgesic.With definite analgesic effects,it can reduce catecholamine and other irritable hormone for postoperative patients and improve patients’ immunity.However,after it reaches certain dosage,it is easy to result in skin itch,nausea and vomiting,as well as respiratory depression,etc.,affecting postoperative intravenous analgesic effects [3].Nalbuphine is a new-type opiate receptor excited antagonist.It develops analgesia and sedation of spinal cord level through excited κ receptor.The medicine has some antagonism.The medicine can antagonize respiratory depression caused by sufentanil and also can develop analgesic effects.Nalbuphine has the weak σ receptor excitement effects,thus it seldom generates discomfortableness or won’t cause elevated blood pressure and increase of heart rate [4].The study aims to make a comparison between two analgesic drugs on analgesic effects of PCIA and occurrence rate of untoward effects in stage of analgesia,so as to provide reference for clinical medication of anesthetists.PurposeBy making a comparison between Nalbuphine and sufentanil on clinical effects of PCIA,more effective postoperative analgesics of cesarean delivery were discussed to provide reference for rational application of postoperative analgesics of caesarean delivery in clinical work for anesthetists.Methods120 patients lying-in women from April 2016 to July 2016 in our hospital were selected.They were divided into nalbuphine group(N group)and sufentanil group(S group)at random.Every group included 60 patients.Lying-in women in N group were given with nalbuphine for PCIA.Lying-in women in S group were given with sufentanil for PCIA.After cesarean delivery for 4h,8h,12 h,24h and 36 h,notch pain scores of patients,uterine contraction scores(Visual Analogue Scale(VAS)and Ramsay method),postoperative PCIA times were recorded respectively.Meanwhile,occurrence of patients’ postoperative complications and patients’ satisfaction for operative analgesia were observed.SPSS20.0 statistical software was applied to do statistical analysis for all experimental data.Measurement data were expressed as mean± standard deviation(?χ±S).Comparison of VAS,Ramsay scores and PCIA times in two groups were conducted t test.The differences of adverse effect rate and patient satisfaction in two groups were compared by using X2 test.α=0.05 was the inspection level.Statistical of Results1.As 4h,8h,12 h,24h and 36 h after operation,there was no statistical significance on notch VAS scores between N group and S group(p >0.05).2.After 4h of operation,uterine contraction VAS scores in N group were lower than S group.There was the statistical significance in difference(p<0.05)3.After 8h,12 h,24h and 36 h of operation,there was no statistical significance on uterine contraction VAS scores in N group and S group(p>0.05)4.After 4h,8h,12 h and 36 h of operation,there was no statistical significance on Ramsay scores in N group and S group(p>0.05)5.After 36 h of operation,total times of PCIA in N group was(4.9±2.7)times and in S group was(5.3±2.1)times;there was no statistical significance between them(p>0.05)6.Occurrence rate(0.00%)of respiratory depression for lying-in women in N group after operation was lower than S group(5.00%).Occurrence rate(0.00%)of nausea and vomiting for lying-in women in N group after operation was lower than S group(8.33%).There was statistical significance in difference(p<0.05).Occurrence rate of skin itch for lying-in women in N group and S group after operation was 0.00%.There was no statistical significance in difference(p>0.05).7.Satisfaction(88.33%)of lying-in women in N group after operation was higher than S group(45.00%).There was statistical significance between them(p<0.05).Conclusion1.Nalbuphine is used for postoperative analgesia of cesarean delivery.Analgesic effect of incision pain is similar to sufentanil.The analgesic effects of visceralgia are superior to sufentanil.2.Nalbuphine is used for postoperative analgesia of caesarean delivery.Sedation level is considerable to sufentanil.There are a few untoward effects and patient satisfaction is high.