Comparison of nalbuphine and dezocine for postoperative analgesia in elderly patients undergoing laparoscopic radical gastric cancer surgery.

Abstract

Objective: Gastric cancer is a prevalent and significant malignancy that occurs throughout the world, with a particularly pronounced impact on the elderly population. This study aims to compare the efficacy of nalbuphine and dezocine in managing pain following laparoscopic radical gastrectomy.

Method: Elderly patients undergoing laparoscopic radical gastrectomy were divided into a nalbuphine (n=50) group and a dezocine (n=50) group according to their anesthesia agent. Anesthesia methods included preoperative intravenous administration of either 0.15 mg/kg nalbuphine or 0.1 mg/kg dezocine, followed by continuous propofol infusion during surgery. Pain and sedation levels were assessed using the VAS and Ramsay Sedation Scale. Secondary indicators included postoperative pain indicators, hemodynamic parameters, recovery time, and adverse anesthetic reactions.

Results: There were no significant differences in baseline data between the two groups, including gender, age, body weight, ASA classification, gastric cancer stage, and surgery duration (all P > 0.05). The nalbuphine group showed superior postoperative pain management compared to the dezocine group, with lower VAS, RSS, inflammatory levels (SP and IL-6) and stress response indicators (all P < 0.05). The nalbuphine group also had shorter awakening time, higher awakening quality, shorter surgery time, and earlier extubation time. Furthermore, the incidence of adverse events was lower in the nalbuphine group.

Conclusion: Nalbuphine provides better postoperative pain relief and was associated with fewer adverse events in elderly patients undergoing laparoscopic radical gastrectomy. These findings suggest that nalbuphine is a safer and more effective analgesic option in this clinical context.