Study on the effect of nalbuphine on pruritus/paresthesia induced by fospropofol disodium under general anesthesia
10.3760/cma.j.cn114015-20220905-00809
- VernacularTitle:纳布啡对磷丙泊酚钠全身麻醉后瘙痒/感觉异常影响的研究
- Author:
Wei ZHANG
1
;
Jingwen FU
1
;
Yonghui WANG
1
;
Tao HE
1
;
Zhihong LU
1
Author Information
1. 空军军医大学西京医院麻醉与围术期医学科，西安 710032
- Publication Type:Journal Article
- Keywords:
Anesthesia, general;
Pruritus;
Fospropofol;
Nalbuphine;
Inflammatory marker
- From:
Adverse Drug Reactions Journal
2023;25(6):327-331
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect and its mechanism of nalbuphine on pruritus/paresthesia induced by fospropofol disodium under general anesthesia.Methods:The study was designed as a prospective, single-center, randomized, double-blind controlled trial. Patients scheduled for surgery under general anesthesia in Xijing Hospital, Air Force Medical University from April to May 2022 were entered and randomly divided into nalbuphine group and control group using the random sequence table method. Patients of both groups were given general anesthesia with fospropofol disodium. Thirty minutes before the end of the surgery, patients in the nalbuphine group received intravenous injection of nalbuphine 0.2 mg/kg (0.1 ml/kg), while those in the control group received intravenous injection of an equal volume of 0.9% sodium chloride injection. Venous blood samples of patients in the 2 groups were collected 5 minutes before anesthesia induction and 5 minutes after awakening to detect levels of serum interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), and S-100 calcium binding protein β (S-100β). The primary indicator of the study was the incidence of pruritus/paresthesia within 30 minutes after extubation; the secondary indicators included time to eye opening upon calling, the maximum pruritus/paresthesia score within 30 minutes after extubation, nausea/ vomiting score, pain score, the incidence of pruritus/paresthesia within 24 hours after operation, the score of patient satisfaction to anesthesia, and the levels of postoperative serum inflammatory markers.Results:A total of 98 patients enrolled the study, 49 in each group. There were no statistically significant differences in gender, age, body mass index, American Society of Anesthesiologists grade, operation type, operation time, or anesthesia time of patients between the 2 groups (all P>0.05). The incidence of pruritus/paresthesia and the score of pruritus/paresthesia 30 minutes after extubation were lower in the nalbuphine group than those in the control group, with statistically significant differences [24.5% (12/49) vs. 61.2% (30/49), P<0.001; 4 (2, 5) vs. 6 (5, 7), P=0.031]. At 24 hours of postoperation, the score of patient satisfaction to anesthesia in the nalbuphine group was higher than that in the control group, with a statistically significant difference [8 (7, 9) vs. 6 (3, 7), P=0.042]. Compared with the control group, the postoperative serum IL-6 in patients of the nalbuphine group was significantly lower [(329.5±105.5) ng/L vs. (398.5±102.6) ng/L, P=0.033], while differences in levels of TNF-α and S-100 β were not statistically significant (all P>0.05). Conclusion:Nalbuphine can significantly reduce the incidence of pruritus/paresthesia induced by fospropofol disodium under general anesthesia and improve the patient satisfaction to anesthesia, and its mechanism may involve the inhibition of inflammatory response by nalbuphine.
