Application of low-dose nalmefene in postoperative patient-controlled intravenous analgesia of elderly patients with hip fracture

doi:10.3969/j.issn.1006-7795.2016.02.026

Abstract

Abstract: Objective To observe the effects of low-dose nalmefene on the postoperative analgesia and side effects of sufentanil and dezocine.Methods Eighty elder patients undergoing hip operations under spinal anesthesia (SA) and given patient-controlled intravenous analgesia(PCIA) were randomly divided into two groups (n=40 each group).Group T was given sufentanil and dezocine plus tropisetron for PCIA, group N was given sufentanil and dezocine plus low-dose nalmefene.The Visual Analogue Scale(VAS) pain scores of two groups were assessed at 2h, 4h, 8h, 12h, 24h, 48h after operation.The side effects and pressing times of PCA were observed and recorded as well.Results The VAS scores in the group N were statistically lower than that of group T postoperatively (P<0.05).The pressing times of PCA in group N was less than that in group T(P<0.05).The incidence of nausea and vomiting, dizziness in group N was significantly lower than group T (P<0.05).There was no occurrence of drowsiness and respiratory depression in group N, but no statistical significance compared with group T.Conclusion Compared with tropisetron, low-dose nalmefene can enhance the analgesic effect safely and reduce the incidence of side effects of sufentanil and dezocine to some extent in elder patients.

Key words: nalmefene, elderly, patient-controlled intravenous analgesia(PCIA), hip fracture

CLC Number:

R971

Wu Dong, Cheng Bin, Gao Maolong, Zhao Jiaxun. Application of low-dose nalmefene in postoperative patient-controlled intravenous analgesia of elderly patients with hip fracture[J]. Journal of Capital Medical University, 2016, 37(2): 241-244.

0
/ / Recommend

Add to citation manager EndNote|Reference Manager|ProCite|BibTeX|RefWorks

URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2016.02.026

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2016/V37/I2/241

References

[1] 陈瑛琪,岳云,卿恩明,等.纳美芬拮抗阿片类药物术后呼吸抑制的效果[J].中华麻醉学杂志,2011,3l(3):307-309.
[2] Gan T J,Ginsberg B,Glass P S,et al.Opioid-sparing effects of a low-dose infusion of naloxone in patient-administered morphine sulfate[J].Anesthesiology,1997,87(5):1075-1081.
[3] Joshi G P,Duff L,Chehade J,et al.Effects of prophylactic nalmefene on the incidence of morphine-related side effects in patients receiving intravenous patien-controlled analgesia[J].Anesthesiology,1999,90(4):1007-1011.
[4] 岳剑宁.舒芬太尼与吗啡预充用于剖宫产术后硬膜外镇痛的比较[J].首都医科大学学报,2009,30(1):107-109.
[5] 高玮,赵琳,段满林,等.地佐辛联合舒芬太尼在上腹部及髋关节置换术后镇痛的临床研究[J].临床麻醉学杂志,2014,30(6):532-535.
[6] Abou-Setta A M,Beaupre L A,Rashiq S,et al.Comparative effectiveness of pain management interventions for hip fracture:a systematic review[J].Ann Intern Med,2011,155(4):234-245.
[7] 刘松,陆蓉,黄成泉,等.老年骨科患者术后不同模式镇痛的临床研究[J].临床麻醉学杂志,2013,29(10):997-999.
[8] 姚鹏,孟凌新,崔健君.超小剂量纳洛酮对吗啡PCIA镇痛效能及副作用的影响[J].中国疼痛医学杂志,2004,10(6):341-344.
[9] Movafegh A,Shoeibi G,Ansari M, et al.Naloxone infusion and post-hysterectomy morphine consumption:a double-blind,placebo-controlled study[J]. Acta Anaesthesiol Scand,2012,56 (10):1241-1249.
[10] Ingman K,Hagelberg N,Aalto S,et al.Prolonged central mu-opioid receptor occupancy after single and repeated nalmefene dosing[J].Neuropsychopharmacology,2005,30(12):2245-2253.
[11] 周汾,李肇端,余剑波.舒芬太尼复合小剂量纳美芬对术后静脉自控镇痛效能的作用[J].中国中西医结合外科杂志,2014,20(3):262-264.
[12] 王楠,张文文,马艳双,等.盐酸纳美芬对老年患者胸科手术麻醉后呼吸抑制和胃肠动力学的影响[J].中国老年学杂志,2015,35(22):6494-6496.
[13] Lesscher H M,Bailey A,Burbach J P,et al.Receptor-selective changes in mu-,delta-and kappa-opioid receptors after chronic naltrexone treatment in mice[J].Eur J Neurosci,2003,17(5):1006-1012.
[14] 胡友洋,杨恒,陈界石,等.小剂量纳美芬增强全麻患者舒芬太尼镇痛作用的临床观察[J].安徽医药,2015,19(9):1802-1803.
[15] 艾青,张志捷,王春光,等.小剂量纳洛酮静脉注射未能减轻吗啡静脉镇痛的不良反应[J].临床麻醉学杂志,2007,23(6):451-453.
[16] 李鹤, 李传翔,宋冬梅,等. 不同麻醉方式对老年骨科患者血流动力学及认知功能的影响[J]. 解放军医药杂志,2015,27(5):86-89.
[17] 张生锁, 潘宁玲,郭航,等. 无囊i-gel喉罩气道无肌肉松弛剂全麻在老年下肢手术中的应用[J]. 解放军医药杂志, 2013,25(6):69-70.
[18] 张红芹, 潘丙德,崔坤鹏,等. 舒芬太尼对高龄患者麻醉诱导时血流动力学影响[J]. 中国煤炭工业医学杂志,2013,16(5):733-735.