C.Delivery; Surgery (Previous), Gynecological Clinical Trial
Official title:
Analgesia Effects of Nalbuphine vs Sulfentanil in Patient-controlled Intravenous Analgesia After Cesarean Section
Cesarean section may result in great trauma and postoperative pain. Besides incision pain,
uterine contraction pain is another source of postoperative pain after cesarean section. In
clinical practice, a large amount of uterine contraction agent is routinely applied after
cesarean section so as to promote involution of uterus and reduce postoperative hemorrhage,
which also causes great uterine contraction pain. Acute pain is the risk factor of chronic
pain, and may postpone the recovery from labour and influence the quality of life of
parturient. Though various analgesia modules have been attempted, more than 20% parturients
still experience severe postoperative pain, and pain management after cesarean section
remains a challenge to anesthesiologists.
This study aim to compare the effects of nalbuphine hydrochloride vs sufentanil citrate on
patient-controlled intravenous analgesia after cesarean section.
Cesarean section may result in great trauma and postoperative pain. Besides incision pain,
uterine contraction pain is another source of postoperative pain after cesarean section. In
clinical practice, a large amount of uterine contraction agent is routinely applied after
cesarean section so as to promote involution of uterus and reduce postoperative hemorrhage,
which also causes great uterine contraction pain. Acute pain is the risk factor of chronic
pain, and may postpone the recovery from labour and influence the quality of life of
parturient. Though various analgesia modules have been attempted, more than 20% parturients
still experience severe postoperative pain, and pain management after cesarean section
remains a challenge to anesthesiologists.
Opiate drugs constitute the baseline medication for postoperative analgesia. However, pure μ
opioid receptor agonist like morphine and fentanyl may induce adverse effects such as
nausea, vomiting, dizziness, drowsiness and respiratory depression. Nalbuphine hydrochloride
is an opiate-like substance structure-related oxymorphone, which is a κ receptor agonist/μ
receptor partial antagonistic type analgesia drug. Specific κ receptor agonist and gene
knockout experiment reveals that κ receptor agonist depresses the visceral pain induced by
chemical stimulation, the effect of which outperforms pure μ opioid receptor agonist.
Studies have discovered that some κ receptor agonists can reduce or inhibit the side effects
of μ receptor agonist such as tolerance or dependence. The adverse effects of μ receptor
agonist such as pruritus, nausea, vomiting, delayed gastric emptying are caused by the drug
on peripheral opioid receptor, and can be relieved by opioid receptor agonist. The structure
of nalbuphine hydrochloride is related to naloxone, an opioid receptor antagonist,
therefore, the incidence of adverse effects of nalbuphine hydrochloride is lower than that
of μ receptor agonist. In recent years, nalbuphine hydrochloride has become more and more
popular in postoperative analgesia. There has been reports on intrathecal administration of
nalbuphine hydrochloride for analgesia after cesarean section, while the effect of
intravenous administration of nalbuphine hydrochloride on analgesia after cesarean section
remains undetermined. This study aim to compare the effects of nalbuphine hydrochloride vs
sufentanil citrate on patient-controlled intravenous analgesia after cesarean section.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
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