丙泊酚分别复合盐酸纳布啡、地佐辛、舒芬太尼用于无痛胃镜的效果比较

发布时间：2018-03-31 04:15

本文选题：丙泊酚　切入点：盐酸纳布啡　出处：《中国药房》2017年03期

【摘要】：目的:比较丙泊酚分别复合盐酸纳布啡、地佐辛、舒芬太尼用于无痛胃镜的麻醉效果和安全性。方法:180例拟行无痛胃镜检查患者随机分为A组(60例)、B组(60例)和C组(60例)。所有患者术前禁食6 h、禁饮4 h,无麻醉前用药。入室后开放静脉,采用多功能心电监护仪监测收缩压(SBP)、舒张压(DBP)、心率(HR)、脉搏血氧饱和度(SpO_2),同时静脉滴注0.9%氯化钠注射液,鼻导管吸氧3 L/min。在此基础上,A组患者静脉注射盐酸纳布啡注射液0.15 mg/kg+丙泊酚注射液1.5 mg/kg;B组患者静脉注射地佐辛注射液5 mg+丙泊酚注射液1.5 mg/kg;C组患者静脉注射舒芬太尼注射液5μg+丙泊酚注射液1.5 mg/kg。各组患者均根据体动、吞咽反射静脉追加20~30 mg丙泊酚注射液,维持一定的麻醉深度。观察各组患者麻醉前(T_0)、睫毛反射消失后(T_1)、置胃镜后(T_2)、苏醒时(T_3)的SBP、DBP、HR、SpO_2,苏醒时间、离院时间,麻醉前后简易智能精神状态检查量表(MMSE)评分及不良反应发生情况。结果:各组患者T_1-3时的SBP、DBP、HR、SpO_2均显著低于同组T_0时,且T_1时C组SpO_2低于A、B组,差异均有统计学意义(P0.05);T_(1-3)时上述指标各组间比较,差异均无统计学意义(P0.05)。A组患者离院时间显著短于B组,差异有统计学意义(P0.05),A、C组间,B、C组间比较差异无统计学意义(P0.05)。A组患者术中呛咳率、术后恶心呕吐发生率显著低于B、C组,差异均有统计学意义(P0.05),B、C组间比较差异无统计学意义(P0.05);A、C组患者术后头晕、嗜睡发生率均显著低于B组,差异均有统计学意义(P0.05),A、C组间比较差异无统计学意义;各组患者术中体动发生率比较,差异无统计学意义(P0.05)。各组患者苏醒时间、麻醉前后MMSE评分比较,差异均无统计学意义(P0.05)。结论:丙泊酚复合盐酸纳布啡用于无痛胃镜的麻醉效果和安全性均优于地佐辛、舒芬太尼。
[Abstract]:Objective: to compare propofol with naporphine hydrochloride and dizosin, respectively. Methods 180 patients with painless gastroscopy were randomly divided into group A (n = 60) and group C (n = 60) and group C (n = 60). Open the vein after entering the room, Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HRN), pulse oxygen saturation (SPO _ 2), and intravenous infusion of 0.9% sodium chloride injection were monitored by multifunctional ECG monitor. On the basis of this, the patients in group A were injected intravenously with naporphine hydrochloride 0.15 mg/kg propofol injection 1. 5 mg / kg propofol injection 5 mg propofol injection 5 mg propofol injection 1.5 mg 路kg ~ (-1) 路min ~ (-1) 路min ~ (-1). Tini injection 5 渭 g propofol injection 1.5 mg / kg. Swallowing reflex vein was supplemented with 20 ~ 30 mg propofol injection to maintain a certain anesthetic depth. The SBP DBP DBP + HRSpO _ 2, recovery time, and hospital absence were observed before anesthesia, after the disappearance of mascara reflex, after the disappearance of mascara reflex, T _ (1), T _ (2), T _ (2) and T _ (3). Results: the SBP DBP HRSPO _ 2 of patients in each group were significantly lower than those of the same group at T0, and the SpO_2 in group C was lower than that in group A at T _ 1 ~ (-1), and the incidence of adverse reactions in group C was significantly lower than that in group T _ (1 ~ 3) before and after anesthesia, and the SpO_2 in group C was lower than that in group B at T _ (1) ~ (-1). There was no significant difference between the two groups when the above indexes were compared. There was no significant difference between the two groups. The time of absence from hospital in group A was significantly shorter than that in group B. There was no significant difference between the two groups. The incidence of nausea and vomiting in group A was significantly lower than that in group B (P 0.05), and the incidence of nausea and vomiting in group A was significantly lower than that in group B (P 0.05), and the incidence of nausea and vomiting in group A was significantly lower than that in group B (P 0.05). There was no significant difference in the incidence of dizziness and lethargy in group A (P 0.05). The incidence of dizziness and somnolence in group C was significantly lower than that in group B (P 0.05), and there was no significant difference between group C and group B (P 0.05). There was no significant difference in the incidence of body movement in each group (P 0.05). The recovery time and MMSE score before and after anesthesia were compared among the patients in each group. Conclusion: the anesthetic effect and safety of propofol combined with naporphine hydrochloride for painless gastroscopy are better than that of dizosin and sufentanil.
【作者单位】：湖北医药学院附属襄阳市第一人民医院麻醉科;
【基金】：襄阳市科技计划指导性项目(No.2015zd12)
【分类号】：R614

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