The preventive effect of dexmedetomidine combined with nalbuphine on fentany-linduced hyperalgesia after nanocarbon laparoscopic hysterectomy

Abstract

This study aimed to explore the preventive effect of dexmedetomidine combined with nalbuphine on fentany-linduced hyperalgesia after nanocarbon laparoscopic hysterectomy. A total of 172 patients diagnosed with cervical cancer and undergoing nanocarbon laparoscopic hysterectomy at Second Hospital of Lanzhou University from February 2017 to October 2019 were selected and divided into a control group (Group C), patients treated with dexmedetomidine (DEX) combined with nalbuphine as the combined group (Group M), the dexmedetomidine group (Group D), and the nalbuphine group (Group N). The imaging and detection rate of sentinel lymph nodes traced by carbon nanoparticles (CNP) was observed and counted, the sedation score and visual analog score (VAS), mechanical pain threshold 24 h before and after the operation, mean arterial pressure (MBP) at each time, heart rate (HR), and adverse reactions were all recorded. The results showed that the total detection rate, sensitivity, and accuracy of CNP tracer sentinel lymph nodes were 97.67%, 90.47%, 95.34%, and 97.67%, respectively. The sentinel and black-stained lymph nodes removed after surgery did not fade. The time of recovery, the HR after intubation, pneumoperitoneum, and extubation in group D were significantly different from the other three groups (P < 0.05). The pain threshold, MBP P < after intubation, and VAS scores at T0–T3 were significantly different from those in other groups (P < 0.05); the Ramsay sedation score was higher in group D than T0–T2 (P < 0.05); the time of first analgesia, the amount of sufentanil, and the number of analgesic pump compressions in group C were significantly different from those in other groups (P < 0.05). The incidence rate of bradycardia in group D was 48.83%, and that of postoperative chills in group C was 30.23%, which was significantly different from other groups (P < 0.05). Therefore, DEX combined with nalbuphine based on nano-carbon laparoscopic hysterectomy could reduce remifentanil-induced hyperalgesia and postoperative side effects, which provided a reference for the prevention of hyperalgesia.