纳布啡预处理对颅脑外科手术患者全麻苏醒期躁动及氧化应激反应的影响  

Effect of Nalbuphine Pretreatment on Emergence Agitation and Oxidative Stress in Patients with Craniocerebral Surgery after General Anesthesia

作　　者：王椰 肖名钦 WANG Ye;XIAO Mingqin(Ji’an Hospital of Shanghai Oriental Hospital,Ji’an 343000,China;不详)

机构地区：[1]上海市东方医院吉安医院,江西吉安343000 [2]江西省吉安市中心人民医院

出　　处：《中国医学创新》2023年第22期23-26,共4页Medical Innovation of China

摘　　要：目的:探讨纳布啡(NAL)预处理对颅脑外科手术患者全麻苏醒期躁动及氧化应激反应的影响。方法:选取2019年4月—2021年3月上海市东方医院吉安医院行颅脑外科手术的患者86例,采用随机数字表法分为观察组和对照组,各43例。两组均采取常规全麻,观察组在麻醉诱导前给予纳布啡预处理,对照组静脉注射同等体积的生理盐水,记录两组全麻苏醒期躁动发生情况、Ramsay评分、疼痛视觉模拟评分法(VAS)评分和拔管时间;比较两组麻醉诱导前,术后24 h时静脉血超氧化物歧化酶(SOD)和丙二醛(MDA)水平;比较两组术后不良反应发生情况。结果:观察组全麻苏醒期躁动发生率为11.63%,显著低于对照组的30.23%(P<0.05)。两组的术后拔管时间差异无统计学意义(P>0.05)。观察组拔管后Ramsay评分低于对照组,术后2 h VAS评分低于对照组,差异均有统计学意义(P<0.05)。麻醉诱导前,两组的SOD、MDA差异均无统计学意义(P>0.05)。术后24 h观察组SOD显著高于对照组,MDA显著低于对照组(P<0.05)。观察组不良反应总发生率为6.98%,显著低于对照组的23.26%(P<0.05)。结论:纳布啡预处理可减少颅脑外科手术患者全麻苏醒期躁动发生率,抑制氧化应激水平,并减少不良反应的发生。Objective:To investigate the effect of nalbuphine(NAL)pretreatment on emergence agitation and oxidative stress in patients undergoing craniocerebral surgery after general anesthesia.Method:Eighty six patients who underwent craniocerebral surgery in Ji’an Hospital of Shanghai Oriental Hospital from April 2019 to March 2021 were randomly divided into observation group and control group,with 43 cases in each group.The observation group was pretreated with Nalbuphine before anesthesia induction,and the control group was intravenously injected with the same volume of Normal Saline.The occurrence of emergence agitation after general anesthesia,Ramsay score,visual analogue scale(VAS)score of pain and extubation time in the two groups were recorded;The levels of superoxide dismutase(SOD)and malondialdehyde(MDA)in venous blood before anesthesia induction and 24 h after operation were compared between the two groups;The incidence of postoperative adverse reactions was compared between the two groups.Result:The incidence of emergence agitation after general anesthesia in the observation group was 11.63%,significantly lower than 30.23%in the control group(P<0.05).There was no significant difference in postoperative extubation time between the two groups(P>0.05).The Ramsay score of the observation group after extubation was lower than that of the control group,and the VAS score at 2 h after operation was lower than that of the control group,the differences were statistically significant(P<0.05).Before anesthesia induction,there were no significant differences in SOD and MDA between the two groups(P>0.05).At 24 h after operation,SOD in the observation group was significantly higher than that in the control group,and MDA was significantly lower than that in the control group(P<0.05).The total incidence of adverse reactions in the observation group was 6.98%,significantly lower than 23.26%in the control group(P<0.05).Conclusion:Nalbuphine pretreatment can reduce the incidence of emergence agitation after general anesthesia in

关 键 词：纳布啡 麻醉预处理 全麻 苏醒期躁动 颅脑手术 氧化应激 

分 类 号：R614.2[医药卫生—麻醉学]