低劑量的Nalbuphine對於小兒術後疼痛的預防效果

Nalbuphine in low dose for the prevention of surgical pain in pediatric population

這個實驗的目的主要在探討小兒接受表淺手術時，在手術結束前靜脈注射低劑量的nalbuphi曲，是否會改善術後疼痛的情形且不會增加術後的併發症。我們根據過去半年的經驗，於民國95年1月到6月底，共收集了80個ASAI-II，年紀在2-10歲接受非緊急性表淺手術的病人。回顧其病歷及麻醉紀錄，將這些病人分為2組：第一組的病人曾在手術要結束之前，接受低劑量nalbuphine（0.lmg／kg），另一組則沒有事先不技與接受任何止痛藥，直到病人喊痛或OPS巧，再依據病人體重給予適當劑量。我們分析清醒的時間、最高的疼痛分數、不良併發症的產生。總共有78個病人被納入統計，其中有2人因資料的不完整而被排除在外。在這兩組中，groupN的最高的疼痛分數為1.50±2.26，而groupS則為6.13±2.48（P<0.05）。手術後的不良反應包括延遲出恢復室的時間或術後噁心偶兔的情形則無明顯差異。結果顯示，在小兒接受非緊急性小手術時，在手術要結束之前給予低劑量的nalbuphine（0.lmg／kg）能有效降低術後疼痛的分數，且不會延長離開恢復室的時間。

The purpose was to determine whether nalbuphine in low dose intravenous injection discontinued before the end of surgery provided well pain control and low complication rate in children undergoing minor surgery.Method: We conducted a retrospective patient chart review between January 2006 and June 2006. Eighty ASA class I-II patients, aged from 2-10 yr were included. Anesthetic records and charts were reviewed to assess differences in 2 groups of patients: those who received preventive low dose of nalbuphine (O.lmg/k:g) and those who did not till awake or OPS>5. We assessed emergence time, highest pain score and complications. Main Results: Seventy-eight children completed the study. Two patients were excluded. The highest pain score was statistically significantly different between the two group, 1.50± 2.26 in group N Vs 6.13± 2.48 in group S (P<0.05). Postoperative adverse effects such as delay discharge from PACU or postoperative nausea and vomiting were no significant difference.Conclusion: Our results show that in children undergoing elective minor surgery, the concurrent use of nalbuphine (O.lmg/k:g) significantly reduces the pain scores without prolonging the time to discharge in this retrospective review.