纳布啡对行切痂植皮术烧伤患者氧化应激及全麻苏醒期躁动的影响  

Effect of Nalbuphine on oxidative stress and agitation during recovery period of general anesthesia in burn patients undergoing scab resection and skin grafting

作　　者：程南[1] 郑卫国[1] 沈迎雁 CHENG Nan;ZHENG Wei-guo;SHEN Ying-yan(Zhejiang Medical and Health Group,Quzhou Hospital,Quzhou(324004),China)

机构地区：[1]浙江省医疗健康集团衢州医院(浙江衢化医院),浙江衢州324004

出　　处：《中国中西医结合外科杂志》2024年第1期81-85,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：衢州市科技项目(2018ASA90248)。

摘　　要：目的:探究纳布啡对烧伤患者行切痂植皮术后全麻苏醒期躁动及氧化应激反应的影响。方法:选取2021年3月-2022年3月我院收治并行切痂植皮术的烧伤患者72例,采用随机数字法分为纳布啡组(n=36)和对照组(n=36)。纳布啡组患者在全身麻醉诱导前10 min静脉注射0.20 mg/kg纳布啡,对照组给予等量生理盐水,比较两组躁动发生率,拔管前(T1)、拔管即刻(T2)、拔管后10 min(T3)、拔管后30 min(T4)的Richmond躁动-镇静评分(RASS)、Ramsay镇静评分,以及术前术后的氧化应激反应和苏醒时间,比较两组恶心呕吐、呼吸抑制、嗜睡、眩晕等不良反应发生情况。结果:与对照组比较,纳布啡组躁动发生率更低,T3、T4时RASS评分均降低,T1、T4时Ramsay镇静评分升高(P <0.05);两组患者术前术后丙二醛(MDA)、脂质过氧化物(LPO)明显下降,超氧化物歧化酶(SOD)明显升高。术后苏醒期,纳布啡组SOD均高于对照组,MDA、LPO低于对照组(P <0.05);两组苏醒时间、恶心呕吐、呼吸抑制、嗜睡、眩晕的不良反应发生率,无统计学差异(P>0.05)。结论:采用纳布啡对行切痂植皮术的烧伤患者有较理想的镇静效果,降低患者全麻苏醒期的躁动,减轻氧化应激反应,且不影响麻醉苏醒时间及不良反应发生率。Objective To investigate the effects of nalbuphine on restlessness and oxidative stress in burn patients after general anesthesia.Methods A total of 72 burn patients admitted to our hospital from March 2021 to March 2022 undergoing scab resection and skin grafting were selected and divided into Nalbuphine group(n=36)and control group(n=36)by random number method.The patients in the Nalbuphine group were given 0.20 mg/kg intravenous injection of Nalbuphine 10 min before induction of general anesthesia,while the control group was given equal amount of normal saline.The incidence of agitation was compared between the two groups.Before extubation(T1),immediately after extubation(T2),10 min after extubation(T3),30 min after extubation(T4),Richmond resting-sedation score(RASS),Ramsay sedation score,oxidative stress response and recovery time before and after extubation.The adverse reactions of nausea and vomiting,respiratory depression,drowsiness and vertigo were counted in two groups.Results Compared with the control group,the incidence of agitation was lower in Nalbuphine group,RASS score was decreased at T3 and T4,and Ramsay score increased at T1 and T4(P<0.05).The malondialdehyde(MDA)and lipid peroxidase(LPO)significantly decreased and superoxide dismutase(SOD)significantly increased in both groups before and after surgery.In the postoperative recovery period,SOD in Nalbuphine group was higher than that in control group,MDA and LPO were lower than that in control group(P<0.05).There were no significant differences in the incidence of recovery time,nausea and vomiting,respiratory depression,lethargy and vertigo between the two groups(P>0.05).Conclusion Nalbuphine has an ideal sedative effect on burn patients undergoing scab resection and skin grafting,reducing agitation and oxidative stress in the recovery period of general anesthesia,and it does not affect the recovery time of anesthesia and the incidence of adverse reactions.

关 键 词：纳布啡 切痂植皮术 全身麻醉 苏醒期躁动 氧化应激反应 

分 类 号：R644[医药卫生—外科学]