关键词:

全身麻醉, 纳布啡, 芬太尼, 复合, 腹腔镜胃癌根治术, 疼痛程度, 睡眠

Abstract:

Objective　To investigate the effect of general anesthesia with nalbuphine and fentanyl for patients undergoing radical gastric cancer surgery. Methods　A total of 120 patients undergoing radical gastrectomy for gastric cancer at Baoji People's Hospital from January to December 2023 were selected for the randomized controlled trial, and were divided into an observation group and a control group by the random number table method, with 60 cases in each group. There were 37 males and 23 females in the control group; they were (61.56 ± 4.21) years old; there were 12 cases of TNM stage I, 35 cases of stage Ⅱ, and 13 cases of stage Ⅲ; there were 14 cases of grade I of American Society of Anesthesiologists (ASA), 31 cases of grade Ⅱ, and 15 cases of grade Ⅲ. There were 31 males and 29 females in the observation group; they were (60.49 ± 4.37) years old; there were 18 cases of TNM stage I, 32 cases of stage Ⅱ, and 10 cases of stage Ⅲ; there were 19 cases of grade I of ASA, 30 cases of grade Ⅱ, and 11 cases of grade Ⅲ. The control group was anesthetized with fentanyl and normal saline, and the observation group with nalbuphine and fentanyl. The stress response indicators, vital signs, pain severities at different time points, sleep quality, and adverse events were compared between the two groups.χ² test, t test, and analysis of variance were used for the statistical analysis. Results　Forty-eight hours after the operation, the levels of superoxide dismutase, aldosterone, cortisol, and renin in the observation group were lower than those in the control group [(95.71±5.30) U/ml vs. (97.95±5.52) U/ml, (86.18±5.26) ng/L vs. (88.36±5.43) ng/L, (22.41±2.35) pg/L vs. (23.38±2.49) pg/L, and (0.75±0.17) μg/L vs. (0.83±0.26) μg/L], with statistical differences (t=2.267, 2.234, 2.194, and 1.995; all P<0.05); the mean arterial pressure, heart rate, and saturation of peripheral oxygen in the observation group were higher than those in the control group [(82.67±3.34) mmHg (1 mmHg=0.133 kPa) vs. (81.43±3.25) mmHg, (82.89±3.32) beats/min vs. (81.67±3.21) beats/min, and (90.32±3.43)% vs. (89.09±3.31)%], with statistical differences (t=2.061, 2.046, and 1.999; all P<0.05); the scores of the 7 items of Pittsburgh Sleep Quality Index in the observation group were better than those in the control group, with statistical differences (t=2.534, 2.263, 2.254, 2.383, 2.401, 2.214, and 2.509; all P<0.05). The postoperative analgesic effect of the observation group was better than that of the control group (F=21.701, P_{between groups}<0.001; F=67 557.071, P_time<0.001; F=7.953, P_interaction<0.05). The incidence rate of adverse events in the observation group was lower than that in the control group [3.33% (2/60) vs. 15.00% (9/60); χ²=4.904; P<0.05]. Conclusion　General anesthesia with nalbuphine and fentanyl during radical gastric cancer surgery can not only stabilize the patients' vital signs and reduce the stress response, but also can achieve good analgesic effect and improve their sleep quality, and is safe.

Key words:

General anesthesia, Nalbuphine, Fentanyl, Compound, Laparoscopic radical gastrectomy for gastric cancer, Pain degree, Sleep