Objective To explore the effects of different dose of nalbuphine on analgesia and recovery in patients after cesarean section.

Methods A total of 108 parturients who underwent cesarean section in the hospital from April 2021 to April 2023 were selected. The parturients were divided into the low-dose group (36 cases), medium-dose group (36 cases) and high-dose group (36 cases) by the random number table method. Three groups were treated with a unified patient-controlled intravenous analgesia regimen. The low-dose, medium-dose and high-dose groups were given 0.10 mg/kg, 0.15 mg/kg and 0.20 mg/kg nalbuphine, respectively. The Ramsay score, comfort score (BCS) and postoperative pain Visual Analogue Scale (VAS) score in three groups were evaluated. The serum pain indicatorsprostaglandin E2 (PGE2), substance P (SP) in myocardial cells, postoperative recovery indicators and adverse reactions among three groups were compared.

Results With the increase of time, the Ramsay scores decreased, and the BCS scores increased in three groups (P ＜ 0.05). Compared with the low-dose group, the Ramsay scores of the medium-dose and high-dose groups were higher after 2 h and 6 h of surgery, and the BCS scores of the medium-dose and high-dose groups were higher after 2 h, 6 h, 12 h and 24 h of surgery (P ＜ 0.05). Compared with the low-dose group, the VAS scores of the fundus at rest, during exercise and under compression in the medium and high-dose groups after 6 h, 12 h, and 24 h of surgery were all decreased (P ＜ 0.05). Compared with 2 hours after the operation, the VAS scores of resting, exercising and compressing the fundus of the uterus in the three groups increased at 6 hours, 12 hours and 24 hours after the operation (P ＜ 0.05). Compared with 6 hours after the operation, the VAS scores of resting, exercising and compressing the fundus of the uterus in the three groups increased at 12 hours after operation, while the VAS scores decreased at 24 hours after the operation (P ＜ 0.05). Compared with 12 hours after operation, the scores of rest, exercise and compression of the fundus at 24 hours after the operation in three groups decreased (P ＜ 0.05). Compared with the low-dose group, the serum levels of PGE2 and SP in the medium and high-dose groups decreased at 12 h, 24 h and 48h after the operation (P ＜ 0.05). Compared with that before the operation, the serum levels of PGE2 and SP in three groups increased at 12 h, 24 h nd 48h after the operation (P ＜ 0.05). Compared with 12 h after the operation, the serum levels of PGE2 and SP in three groups increased after 24 hours of operation, and decreased after 48 hours of operation (P ＜ 0.05). Compared with 24 hours after the operation, the serum levels of PGE2 and SP in three groups decreased after 48 hours of operation (P ＜ 0.05). Compared with the low-dose group, the time of first getting out of bed for activity, time of gastrointestinal exhaust and time of first urination in the medium and high-dose groups were all shortened (P ＜ 0.05). The total incidence of adverse reactions within 48 hours after surgery in the high-dose group (22.22%) was higher than that in the low-dose and medium-dose groups (P ＜ 0.05).

Conclusions Nalbuphine has a good analgesic effect after cesarean section, can reduce the release of pain mediators, and is conducive to postpartum recovery. Considering comprehensively, the 0.15 mg/kg of nalbuphine can achieve a good analgesic effect, and has good safety.