关键词: 纳布啡, 超前镇痛, 腹腔镜下肝部分切除术, Ramsay 镇静评分, NRS 疼痛评分

Abstract: Objective To investigate the clinical effect and safety of nalbuphine preanalgesia in laparoscopic partial hepatectomy and provide the basis for its rational use in laparoscopic hepatectomy. Methods 60 cases accepted laparoscopic partial hepatectomy in Hepatobiliary and Pancreatic Surgery of The Central Hospital of Wuhan from March 2020 to March 2021，who conforming to the standard were randomly divided into a control and an experimental group with 30 cases. The experimental group was given 0. 2 mg/kg nalbuphine （Yichang Humanwell Pharmaceutical Co. ，Ltd. ，2 mL∶20 mg）intravenous infusion before surgery，while the control group was given the same amount of normal saline infusion simultaneously. NRS pain scores and Ramsay sedation scores at 2，4，8，12，24，and 48 h after surgery were recorded and evaluated，and additional analgesia times and doses at 48 h after surgery were calculated. The incidence of nausea，vomiting，dizziness，abdominal distension，respiratory depression，and other adverse reactions was recorded. Results The NRS pain scores of the experimental group at 2，4，8，12，and 24 h after operation were significantly lower than those of the control group（P < 0. 05）. The Ramsay sedation score at 24 h after operation was significantly higher in the experimental group compared with that of the control group（P < 0. 05）. There was no significant difference in NRS pain score and Ramsay sedation score between the two groups 48 h after surgery（P > 0. 05）. The number and dose of additional analgesia at 48 h after operation in the experimental were significantly less than those in the control group（P < 0. 05）. There was no significant difference in the incidence of postoperative adverse reactions between the two groups （P > 0. 05）. Conclusion The prophylactic application of nalbuphine can significantly relieve postoperative pain in patients undergoing laparoscopic partial hepatectomy，which is effective and safe in clinical application.

Key words: nalbuphine, pre-emptive analgesia, laparoscopic partial hepatectomy, Ramsay sedation score, NRS pain score