Abstract：Objective: To investigate the effect of nalbuphine combined with remifentanil on gastric emptying function in mechanically ventilated patients. Methods: A total of 100 patients requiring mechanical ventilation were selected from this hospital from July to December 2020, and they were randomly divided into remifentanil group and combination group, with 50 cases in each group. Both groups were treated with mechanical ventilation. The remifentanil group was given continuous intravenous pumping of remifentanil for 48 hours for analgesia and sedation, and the combination group was given remifentanil and given nalbuphine continuous intravenous pumping for 48 hours. Ultrasound was used to detect the gastric emptying time (GET) and motility index (MI) before analgesia and 48 hours after analgesia and sedation. Analgesia before and after analgesia and sedation 1 hour, 2 hours, 12 hours, 24 hours, 48 hours,heart rate (HR) and mean arterial pressure (MAP) were recorded. The occurrence of adverse reactions of patients were observed. Results: After analgesia and sedation, GET was prolonged and MI decreased in the two groups, and GET was shortened and MI increased in the combined group (P<0.05). HR slowed and MAP decreased at 1 hour, 2 hours, 12 hours, 24 hours, 48 hours after analgesia and sedation in the two groups (P<0.05). There was no significant difference in HR and MAP at each time point after analgesia and sedation in the two groups (P>0.05). There was no significant difference in the adverse reaction rate between the two groups (P>0.05). Conclusion: Nalbuphine combined with remifentanil is safe and reliable, can shorten the GET of mechanically ventilated patients, and increase the MI without increasing the incidence of adverse reactions.
倪逊, 许可, 丁婷婷, 巩丹丹, 陆姗姗, 林爱华. 床边超声评估纳布啡联合瑞芬太尼对机械通气患者胃排空功能的影响[J]. 河北医学, 2021, 27(5): 855-859.
NI Xun, XU Ke, DING Tingting, et al. Bedside Ultrasound Evaluation of the Effect of Nalbuphine Combined with Remifentanil on Gastric Emptying Function in Mechanically Ventilated Patients. HeBei Med, 2021, 27(5): 855-859.
[1] Elgebaly AS,Sabry M.Sedation effects by dexmedetomidine versus propofol in decreasing duration of mechanical ventilation after open heart surgery [J].Ann Card Anaesth,2018,21(3):235~242. [2] Piwowarczyk P,Kutnik P,Borys M,et al.Influence of early versus late supplemental parenteraL nutrition on long-term quality of life in ICU patients after gastrointestinal oncological surgery (hELPLiNe): study protocol for a randomized controlled trial [J].Trials,2019,20(1):777. [3] Cao S,Karmouta R,Li DG,Din RS,et al.Opioid prescribing patterns and complications in the dermatology medicare population [J].JAMA Dermatol,2018,154(3):317~322. [4] 庞红利,李洪影,何东海,等.纳布啡抑制瑞芬太尼诱导的大鼠痛觉过敏[J].基础医学与临床,2020,40(5):65~68. [5] Liu Y,Gao YK,Yao L,Li L,et al.Modified B-ultrasound method for measurement of antral section only to assess gastric function and guide enteral nutrition in critically ill patients [J].World Gastroenterol,2017,23(28):5229~5236. [6] 吴永红,高燕,李勇,等.胃肠道功能障碍分级干预在危重症患者中的应用[J].中华护理杂志,2018,53(4):423~427. [7] Hungerford JL,O'Brien N,Moore-Clingenpeel M,et al.Remifentanil for sedation of children with traumatic brain injury [J].Intensive Care Med,2019,34(7):557~562. [8] Jehangir A,Parkman HP.Chronic opioids in gastroparesis: relationship with gastrointestinal symptoms,healthcare utilization and employment [J].World Gastroenterol,2017,23(40):7310~7320. [9] Gerak LR,Minervini V,Latham E,et al.Methocinnamox produces long-lasting antagonism of the behavioral effects of μ-opioid receptor agonists but not prolonged precipitated withdrawal in rats [J].Pharmacol Exp Ther,2019,371(2):507~516. [10] Haw AJ,Meyer LC,Fuller A.Nalbuphine and butorphanol reverse opioid-induced respiratory depression but increase arousal in etorphine-immobilized goats (Capra hircus) [J].Vet Anaesth Analg,2016,43(5):539~548. [11] Reiter PD,Clevenger AC.Nalbuphine reduces opioid-associated urinary retention in pediatric patients [J].Pediatr Crit Care Med,2019,20(5):e240~e244. [12] Ibrahim AS,Aly MG,Thabet ME,et al.Effect of adding nalbuphine to intrathecal bupivacaine with morphine on postoperative nausea and vomiting and pruritus after elective cesarean delivery: a randomized double blinded study [J].Minerva Anestesiol,2019,85(3):255~262. [13] Gupta M,Gupta P.Nalbuphine pretreatment for prevention of etomidate induced myoclonus: a prospective,randomized and double-blind study [J].Anaesthesiol Clin Pharmacol,2018,34(2):200~204.
2021, Vol. 27 
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