Effect of nalmefene hydrochloride in improving the postoperative resuscitation and analgesia in elderly patients with gastric cancer

Objective:To investigate the effects of nalmefene hydrochloride in improving the postoperative resuscitation and analgesia in elderly patients with gastric cancer.Methods:Ninety elderly gastric cancer patients scheduled by operation were randomly divided into the control group,low-dose nalmefene group and high-dose nalmefene group(30 cases each group).The control group was intravenously injected with 2 mL normal saline at the end of surgery,and a PCIA analgesia pump(filling with 0.2 mg/kg butorphanol tartrate) were connected.The low-dose and nalmefene high-dose groups were intravenously injected with 0.25 and 0.50 μg/kg of nalmefene hydrochloride at the end of surgery,and a PCIA analgesia pump(filling with 0.2 mg/kg butorphanol tartrate and 2 μg/kg of nalmefene hydrochloride) were connected.The postoperative spontaneous breathing recovery time,eye opening time,extubation time,Narcotrend value and mental state(including conscious disturbance,agitation,and delirium) of patients between three groups were compared,and the VAS score,ramsay sedation score and postoperative nausea and vomiting(PONV) score between three groups were compared after 1,2,6,12,24 and 48 hours of operation.Results:The recovery time of spontaneous breathing,eye opening time and extubation time in high-dose group were significantly lower than those in low-dose group and control group(P<0.01),and which in low-dose group was significantly less than that in control group(P<0.01).The differences of the Narcotrend value between three groups at administration were not statistically significant(P>0.05),the Narcotrend values in high-dose group after 5,10 and 15 minutes of administration were significantly higher than those in low-dose group and control group(P<0.01),and the Narcotrend values in low-dose and high-dose groups after 20 minutes of administration were significantly higher than that in control group(P<0.01).The differences of the conscious disturbance,agitation,and delirium between three groups were not statistically significant(P>0.05).The VAS scores in high-dose group after 1 h and 48 h of operation were significantly lower than that in control group(P<0.01).The scores of Ramsay sedation and PONV in high-dose group after 1 h to 48 h of operation were significantly lower than that in control group(P<0.01).Conclusions:Nalmefene hydrochloride can effectively improve the postoperative recovery,and allivate the adverse reactions of opioid drug,which is worthy of promotion in clinic.