Effectiveness of Dexmedetomidine Combined with Nalbuphine on Patients Undergoing Orthognathic Surgery and Its Impact on the Severity of Postoperative Nausea and Vomiting
DAI Weilan, et al
Affiliated Stomatological Hospital, Xiamen Medical College, Fujian Xiamen 361000, China
Abstract：Objective: To explore the efficacy of dexmedetomidine combined with nalbuphine in patients undergoing orthognathic surgery (OGS) and its impact on the severity of postoperative nausea and vomiting (PONV). Methods: Ninety patients who underwent OGS in our hospital from August 2019 to December 2024 were randomly divided into a control group (n=45, receiving postoperative analgesia with sufentanil and nalbuphine) and a study group (n=45, receiving intraoperative infusion of dexmedetomidine and postoperative analgesia with sufentanil and nalbuphine) using a block randomization method. The satisfaction with analgesia, analgesic effect, sleep quality, severity of PONV, and incidence of agitation during the recovery period were compared between the two groups. Results: The overall satisfaction rate of pain relief in the research group (86.67%) was higher than that in the control group (64.44%) (P<0.05). Comparison of time-point, between-group, time-point and between-group interactions for visual analogue scale (VAS) and Pittsburgh Sleep Index (PSQI) scores showed statistical significance (P<0.05). The VAS scores of the study group were lower than those of the control group at 8, 16, 24, and 48 hours after surgery (P<0.05), and the PSQI scores of the study group were lower than those of the control group at 24 and 48 hours after surgery (P<0.05). The total incidence of PONV in the study group (11.11%) was lower than that in the control group (60.00%) within 0-12 hours after surgery. However, the total incidence of PONV in the study group (4.44%, 6.67%) within 12-24 hours and 24-48 hours after surgery was not statistically significant compared to the control group (11.11%, 8.89%) (P<0.05). The incidence of agitation during the awakening period in the study group was 6.67 (3/45), which was lower than the control group at 28.89% (13/45) (P<0.05). Conclusion: The combination of dexmedetomidine and nalbuphine in OGS patients can improve analgesic satisfaction, enhance analgesic efficacy and sleep quality, and reduce the severity of PONV and the incidence of agitation during the recovery period.
戴伟兰, 陈白烨, 蓝丽芳, 谢珊珊. 右美托咪定联合纳布啡对正颌手术患者的效果及对术后恶心呕吐严重程度的影响[J]. 河北医学, 2025, 31(6): 1048-1053.
DAI Weilan, et al. Effectiveness of Dexmedetomidine Combined with Nalbuphine on Patients Undergoing Orthognathic Surgery and Its Impact on the Severity of Postoperative Nausea and Vomiting. HeBei Med, 2025, 31(6): 1048-1053.
[1] Hou L,He Y,Yi B,et al.Evaluation of soft tissue prediction accuracy for orthognathic surgery with skeletal class Ⅲ malocclusion using maxillofacial regional aesthetic units[J].Clinical Oral Investigations,2023,27(1):173-182. [2] Claus J D P,Almeida M S,Lopes H J C.The Use of bone substitute blocks in minimally invasive orthognathic surgery:enhancing jaw stability and healing[J].The Journal of Craniofacial Surgery,2024,35(8):787-790. [3] 王晓宁,张丽红,张彤,等.持续输注超低剂量右美托咪定对老年CAS患者血流动力学和术后认知功能的影响[J].中国医科大学学报,2024,53(3):193-197. [4] 余理想,于振坤,杨传宗,等.不同剂量瑞芬太尼联合右美托咪定对环杓关节脱位夹持式复位的影响[J].临床麻醉学杂志,2024,40(10):1034-1038. [5] 李明明,白明松,刘静,等.纳布啡联合酮咯酸氨丁三醇预处理对电视胸腔镜外科手术后急性痛觉过敏的影响[J].中国内镜杂志,2022,28(9):47-52. [6] 孙西龙,刘焕,吴志林.胸腔镜直视下肋间神经阻滞联合纳布啡用于胸腔镜肺段切除术后多模式镇痛[J].临床外科杂志,2023,31(12):1213-1216. [7] Wahlstrom D,Toscano C,Havard D.Enhanced recovery after orthognathic surgery:a retrospective comparison study of 56 patients[J].British Journal of Oral and Maxillofacial Surgery,2023,61(2):171-175. [8] Liu K,Luo S,Cao J.Guo Y.Zhang Y.Li B.Zhang L.Wang X.Objective assessment of visual attention in orthognathic surgery training based on eye tracking[J].Journal of Cranio-Maxillofacial Surgery,2024,52(1):65-70. [9] Delpachitra S N,Bordbar P.Surgical accuracy of CAD/CAM splints using virtual surgical planning in orthognathic surgery:policy implications for healthcare in Australia[J].ANZ journal of surgery,2023,93(11):2742-2747.
2025, Vol. 31 
冀公网安备13080202000786号