Anesthetic and analgesic effect of nalbuphine combined with local anesthetics in brachial plexus block for upper limb orthopedic surgery
XIE Yan
CAO Xing
SHENG Chunping
BAO Dongmei
WANG Lisuo
Abstract：Objective To explore the effects of brachial plexus block with nalbuphine combined with local anesthetics on anesthetic efficacy and postoperative analgesia in patients undergoing upper limb orthopedic surgery.Methods A prospective study was conducted.A total of 108 patients scheduled for upper limb orthopedic surgery at Dongtai Hospital of Chinese Medicine from January 2023 to April 2025 were selected and randomly divided into three groups:Group N(n=36,treated with ropivacaine plus lidocaine plus nalbuphine),Group D(n=36,treated with ropivacaine plus lidocaine plus dexamethasone),and Group S(n=36,treated with ropivacaine plus lidocaine).The anesthetic effects(onset time of sensory block and motor block,analgesia duration),postoperative pain intensity(Visual Analogue Scale(VAS)scores),hemodynamic indicators(heart rate(HR),mean arterial pres-sure(MAP)),and perioperative adverse reactions were compared among the three groups.Results Among Group N,Group D,and Group S,the onset time of sensory block((2.97±0.90),(4.05±1.03),and(5.20±1.37)min,respectively)and the onset time of motor block((8.91±2.76),(11.22±2.80),and(13.63±3.14)min,respectively)were progressively increased(F=35.838,23.763,both P＜0.05),and the duration of analgesia((11.06±1.27),(8.42±1.10),and(7.21±1.08)h,respectively)was progressively decreased(F=104.934,P＜0.05).At 2,4,8,and 12 hours postoperatively,the VAS scores were(1.34±0.44),(1.57±0.46),(1.88±0.51),and(2.84±1.27)points in Group N,(1.51±0.50),(1.85±0.52),(2.85±0.62),and(3.69±1.32)points in Group D,(1.87±0.61),(2.17±0.72),(3.06±0.93),and(4.55±1.44)points in Group S,respectively.The VAS scores in the three groups showed a gradual increase(F=9.696,9.731,28.351,14.543,all P＜0.05).At T2,the heart rates in Group N((81.35±9.14)beats/min),Group D((84.42±8.95)beats/min),and Group S((87.62±8.93)beats/min)were gradually increased(F=4.362,P＜0.05).At T3,the mean arterial pressures of Group N((87.51±6.22)mmHg(1 mmHg=0.133 kPa)),Group D((88.85±6.37)mmHg),and Group S((92.19±7.23)mmHg)were gradually increased(F=4.769,P＜0.05).The incidence of perioperative adverse reactions in Group N was 13.89％(5/36),and there was no statistically significant difference compared to Group D(11.11％(4/36))and Group S(2.78％(1/36))(Fisher's exact test,P=0.266).Conclusion Nalbuphine combined with local anesthetics provided the optimal effect for brachial plexus block.Dexamethasone combined with local anesthetics was superior to local anesthetics alone.All three regimens had comparable safety.
Keywords：nalbuphineropivacainelidocainebrachial plexus blockupper limb orthopedic surgerypostoperative analgesiaanesthetic effect
Publication Date：2026-01-25
Online Publishing Date：2026-03-03(First online date of this platform, not the publication date of the document)
Pages：5( 42-46 )