Effect Of Different Doses Of Nalbuphine Preconditioning Combined With Remifentanil On The Recovery Quality Of Patients Undergoing Vocal Cord Polypectomy Under Suspension Laryngoscopy

Objective:To investigate the effect of different doses of nalbuphine preconditioning combined with remifentanil on the recovery quality of patients undergoing vocal cord polypectomy under suspension laryngoscopyMethods:A total of 90 patients undergoing vocal cord polypectomy under general anesthesia with suspension laryngoscope.All surgery were day surgery,males or females,aged from 20 to 65 years old,ASA grade I or II.The patients were randomly divided into three groups,30 cases in each group:remifentanil group（group R）,0.1mg/kg nalbuphine combined with remifentanil group（group N1）and0.2mg/kg nalbuphine combined with remifentanil group（group N2）.In group R,5ml saline was injected intravenously 5 minutes before anesthesia induction,group N1and group N2 received intravenous injection of nalbuphine 0.1mg/kg and 0.2mg/kg respectively 5 minutes before anesthesia induction（both diluted to 5ml with saline）.MAP and HR were recorded at the time of admission（T₀）,immediately after anesthesia induction（T₁）,immediately after endotracheal intubation（T₂）,when entering PACU（T₃）,and immediately after extubation（T₄）;Record the dosage of propofol and remifentanil;The recovery time of spontaneous breathing,eye opening time,extubation time and PACU retention time were recorded;the adverse reactions such as respiratory depression,nausea and vomiting,emergence agitation,excessive sedation and dizziness were recorded during PACU;sore throat was recorded 1 hour after extubation（T₅）,2 hours after extubation（T₆）and 6 hours after extubation（T₇）.Result:Intra-group comparison:compared with T₀,MAP and HR at T₄in the three groups were significantly higher（P<0.05）.Comparison between groups:compared with group R,MAP and HR at T₄in N1 group and N2 group were lower（P<0.05）,The dosage of remifentanil was lower（P<0.05）,the incidence of emergence agitation in PACU was lower（P<0.05）,the incidence of postoperative sore throat was lower（P<0.05）.There was no significant difference in the dosage of propofol and the recovery time of spontaneous respiration,the incidence of respiratory depression,nausea and vomiting（P>0.05）.Compared with N2 group,the eye opening time,extubation time and PACU retention time in N1 group were significantly shorter（P<0.05）,and the incidence of excessive sedation and dizziness in PACU was lower（P<0.05）.There was no significant difference in the Dosage of propofol and remifentanil and the incidence of respiratory depression,nausea and vomiting,emergence agitation and postoperative sore throat（P>0.05）.Conclusion:0.1mg/kg nalbuphine preconditioning combined with remifentanil can shorten the recovery time of general anesthesia,reduce the incidence of emergence agitation and excessive sedation,relieve postoperative sore throat,improve the recovery quality in patients undergoing vocal cord polypectomy under suspension laryngoscope.