Abstract: Objective To observe the efficacy of patient-controlled intravenous analgesia (PCIA) using sufentanil supplement with nalbuphine on patients underwent laparoscopic total hysterectomy. Methods A total of 180 patients, age ranged from 18 to 65 year, BMI 18-25 kg/m2, ASA physical status Ⅰ-Ⅱ, undergoing laparoscopic total hysterectomy were selected. They were randomly divided into 3 groups (n=60 for each group): sufentanil group (group S), nalbuphine group (group N) and sufentanil supplement with nalbuphine group (group NS). PCIA pump was given at the end of the operation with 5 mL bonus loading. The total amount of PCIA was 100 mL, and which was programmed to deliver 0.5 mL each time with a lockout interval of 15min and the background infusion amount of 2 mL/h. In the group S, PCIA regiment composed of sufentanil 2 μg/kg and 10mg tropisetron in 100 mL of normal saline. In the group N, PCIA regiment composed of nalbuphine 2 mg/kg and 10 mg tropisetron in 100 mL of normal saline. In the group NS, PCIA regiment composed of sufentanil 1 mg/kg, nalbuphine 1 mg/kg and 10 mg tropisetron in 100 mL of normal saline. The VAS score and Ramsay score were recorded after the operation, and the number of effective compression of PCIA was also recorded. Adverse reactions were documented in details. Results There was no significant difference in general condition between the three groups (P＞0.05). There was no significant difference in VAS scores between the 3 groups at all time points (P＞0.05). PCIA press times were significantly more in group S than those of group N (P＜0.05). But there was no significant difference between group S and group NS (P＞ 0.05). Ramsay scores were higher in group N than those in group S and group NS (P＜0.05). But there was no significant difference between group S and group NS (P＞0.05). The incidence of nausea and vomiting were higher in group S than those in group N (P＜0.016 7), but there was no statistical difference in group NS compared with that of group S and group N (P＞ 0.016 7). The additional dose of tropisetron was higher in group S than that in group N and group NS (P＜0.05), but there was no statistical difference between group N and group NS (P＞0.05). Conclusion Nalbuphine supplement sufentanil has great efficiency for postoperative patient-controlled intravenous analgesia in laparoscopic hysterectomy. It not only can avoid the excessive sedative effect produced by large doses of nalbuphine, but also reduces the amount of sufentanil, thus reducing the incidence of nausea and vomiting, and the analgesic effect is satisfaction.

Key words: nalbuphine, sufentanil, laparoscopy, hysterectomy, analgesia