Effect Of Nalbufine Hydrochloride Combined With Dexmedetomidine On Analgesic Efficacy And Inflammatory Factors Of IL-6 And IL-10 In Patient-controlled Intravenous Analgesia For Patients After Gynecological Laparoscopic Surgery

Objective:This study probe into the analgesic effect of nalbufine hydrochloride combined with dexmedetomidine in patient-controlled intravenous analgesia(PCIA)after gynecological laparoscopic surgery and its effect of inflammatory factors of IL-6and IL-10.Methods: A total of 78 patients were selected who underwent gynecological laparoscopic surgery and genernal anaesthesia from November 2019 to December 2020 in Affiliated Zhongshan Hospital Of Dalian University,ASA Ⅰ or Ⅱ,the age at 18 to65,the BMI at 18.5～27.9kg/m~2.All of 78 patients were divided into two groups by random digits table:nalbuphine group(N group)and nalbuphine combined with dexmedetomidine group(ND group),39 cases in each group.Both groups underwent patient-controlled intravenous analgesia(PCIA).The group N received nalbuphine2.0mg/kg and dolasetron 12.5mg.The group ND received nalbuphine 2.0mg/kg,dexmedetomidine 1ug/kg and dolasetron 12.5mg.The diluent of analgesic pump solution in both groups was 0.9% sodium chloride injection,and the total amount of the solution was 150 ml.The continuous pumping speed of 2ml/h,the single self-controlled dose of 0.5ml and the locking interval of 15 min were used for postoperative analgesia lasting 48 hours.Observation index: The analgesic effect(VAS score),sedative effect(Ramsay score)and comfort level(BCS score)of each patient were recorded at the time points of 1h,6h,12 h,24h and 48 h after surgery.The serum inflammatory factors IL-6and IL-10 levels were measured and recorded one day before surgery,the first day after surgery and the second day after surgery.The total effective of times patients used PCIA and adverse reactions were recorded within 48 hours after surgery.Results:1.General data:there were no statistical significance in age,BMI and operation time between the two groups(P>0.05).2.Analgesic effect(VAS score): VAS scores were lower at every recorded time after surgery,in ND group than those in N group(P<0.05).3.Sedative effect(Ramsay score): Ramsay scores of ND group at 24 h and 48 h after surgery were significantly higher than those of N group(P<0.05).4.Comfort(BCS score): The BCS scores of were higher at 12 h,24h and 48 h after surgery,in the ND group than those in the N group(P<0.05).5.The level of inflammatory factors in the serum:There were no significance in IL-6 and IL-10 levels between the two groups one day before surgery(P>0.05).In comparison with the N group,the levels of IL-6 were lower in the ND group on the first day and the second day after surgery(P<0.05).In comparison with the N group,the levels of IL-10 were higher in the ND group on the first day and the second day after surgery(P<0.05).6.The total effective of times patients used PCIA for 48 hours after surgery:N group more than ND group,the difference being significant(P<0.05).7.Side effect: there were no statistical difference in the side effects between the two groups(P>0.05).Conclusions: Nabuphine hydrochloride combined with dexmedetomidine in patient-controlled intravenous analgesia after gynecological laparoscopic Surgery has exact analgesic effect,higher comfort,fewer adverse effect and can also regulate the inflammatory response of patients.