| 纳布啡复合丙泊酚用于无痛结肠镜检查术的临床效果 |
| 投稿时间：2016-06-17 修订日期：2016-06-17 点此下载全文 |
| 引用本文：周俊辉,孟睿,刘晓乐,房芳,奚高原,孟宪慧.纳布啡复合丙泊酚用于无痛结肠镜检查术的临床效果[J].医学研究杂志,2017,46(2):112-116 |
| DOI：
10.11969/j.issn.1673-548X.2017.02.029 |
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| 中文摘要:目的 评价纳布啡复合丙泊酚静脉全身麻醉用于无痛结肠镜检查术的临床效果。方法 择期行无痛结肠镜检查术的患者60例，年龄35~65岁，采用数字表法将所有患者随机均分为两组：纳布啡复合丙泊酚组（N组，n=30）及舒芬太尼复合丙泊酚组（S组，n=30）患者分别静脉注射纳布啡0.1mg/kg及舒芬太尼0.1μg/kg，静脉注射时间均>60s，给药5min后两组均静脉注射丙泊酚1.0mg/kg，镜检过程中丙泊酚泵注速率为4~6mg/（kg·h）。待患者睫毛反射消失后即行结肠镜检查术。记录两组患者麻醉诱导时间、检查操作时间、麻醉苏醒时间、恢复时间及术中丙泊酚用量。记录两组患者麻醉前5min（T0）、睫毛反射消失时（T1）、检查开始即刻（T2）、镜身过脾曲时（T3）、镜身过肝曲时（T4）、术毕时（T5）、术毕后5min（T6）及术毕后10min（T7）时平均动脉压（MAP）、心率（HR）、呼吸频率（RR）及脉搏血氧饱和度（SpO2）；记录两组患者术中及术毕清醒后5、15、30、45、60min时视觉模拟评分（VAS）和Ramsay镇静评分。记录两组患者术毕清醒后60min内的不良反应发生率。结果 两组患者麻醉诱导时间、检查操作时间、麻醉苏醒时间、恢复时间及丙泊酚用量比较，差异均无统计学意义（P>0.05）。两组患者T0~T7时的MAP、HR、RR及SpO2差异均无统计学意义（P>0.05）。两组患者术毕5~60min时的VAS、Ramsay镇静评分比较，差异均无统计学意义（P>0.05）。两组患者术中高血压、窦性心动过速、呛咳、体动反应、呃逆及注射痛等发生率差异均无统计学意义（P>0.05），而N组患者术毕清醒后60min内的恶心、呕吐、呼吸抑制及躁动不安发生率均较S组降低（P<0.05）。结论 剂量为0.1mg/kg的纳布啡复合丙泊酚静脉全身麻醉用于无痛结肠镜检查术的临床效果较好，且不增加患者术后的不良反应，可安全应于临床。 |
| 中文关键词:纳布啡 丙泊酚 结肠镜 无痛 |
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| Clinical Efficacy of Nalbuphine Combined with Propofol in Painless Colonoscopy Examination |
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| Abstract:Objective To explore the clinical efficacy and safety of nalbuphine combined with propofol in painless colonoscopy examination. Methods Sixty patients, aged 35-65 years, undergoing painless colonoscopy examination, were randomly divided into two groups as follows:patients of nalbuphine combined with propofol group(N groups, n=30) and sufentanil combined with propofol group(S group, n=30) were respectively injected intravenously with nalbuphine at the dose of 0.1mg/kg and sufentanil at the dose of 0.1μg/kg for more than 60s, and after 5min, propofol was injected intravenously at an initial dose of 1.0mg/kg, following continuous intravenously pumped at a rate of 4-6mg/(kg·h). After eyelash reflex of patients disappeared, painless colonoscopy examination was performed. Time of anesthesia induction, time of examination, time of anesthesia waking, time of recovery and the dosage of propofol were recorded in the two groups. Mean artery blood pressure(MAP), heart rate(HR), respiratory rate(RR) and oxygen saturation(SpO2) of the patients were recorded respectively 10 min before anesthesia(T0), the onset of eyelash reflex disappeared(T1), the onset of examination initiating(T2), when lens body through splenic flexure(T3), when lens body through hepatic flexure(T4), the end of examination(T5), 5 min(T6) and 10min(T7) after examination in the two groups. Visual analogue scale(VAS) and Ramsay sedation scores of the patients were recorded 5, 15, 30, 45 and 60min after anesthetic recovery in the two groups. The adverse reactions during examination and within 60min after examination were analyzed in the two groups. Results There was no statistical significance(P>0.05) in time of anesthesia induction, time of examination, time of anesthesia waking, time of recovery and the dosage of propofol between the two groups. There was no statistical significance(P>0.05) in MAP, HR, RR and SpO2 at different time points between the two groups. There was no statistical significance(P>0.05) in VAS and Ramsay sedation scores 5-60 min after examination between N group and S group. There was no statistical significance(P>0.05) in the incidences of intraoperative adverse reactions including hypertension, sinus tachycardia, bucking, restless moving, hiccups and injection pain between the two groups, while the incidences of nausea, vomit, respiratory depression and restlessness within 60 min after anesthetic recovery in N group were lower(P<0.05) than those in S group. Conclusion The clinical effect of nalbuphine(0.1mg/kg) combined with propofol on painless colonoscopy examination is favourable, without increasing postoperative adverse reactions, and thus being safely applied in clinical practice. |
| keywords:Nalbuphine Propofol Colonoscopy Painless |
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