布托啡诺联合丙泊酚、戊乙奎醚在胃镜检查中的应用

Clinic application of butorphanol combined with propfol and penehyclidine in the gastroscopy

目的:研究布托啡诺联合丙泊酚、戊乙奎醚在胃镜检查的麻醉效果及安全性。方法:90例患者随机分为3组(n=30):布托啡诺组(B组)、丙泊酚组(P组)和对照组(C组)。B组使用布托啡诺1 mg、戊乙奎醚0.5 mg和丙泊酚静脉缓慢推注行胃镜检查术;P组使用丙泊酚、戊乙奎醚0.5 mg行胃镜检查术;C组只使用咽喉表面麻醉。记录三组患者麻醉前(T0)、术后1 min(T1)、术后5 min(T2)、术后10min(T3)血压(BP)、心率(HR)、脉搏血氧饱和度(SPO2)的变化及不良反应,并记录B、P两组病人丙泊酚的用量及清醒时间。结果:与T0比较:B组BP在T1点明显下降(P<0.05),但不低于基础血压20%。HR、SPO2均在正常范围变化,无临床意义(P>0.05);P组BP、HR、SPO2在T1-3点均明显下降(P<0.05),T1点30%患者BP下降值大于基础血压20%;C组在T1-3各点BP、HR均显著增高(P<0.05)。B组丙泊酚用量为(1.5±0.5)mg/kg,P组丙泊酚用量为(2.1±0.8)mg/kg,两组比较有统计学意义(P<0.05);B组清醒时间为(2.5±1.2)min,P组为(6.5±2.5)min,两组比较有统计学意义(P<0.05)。结论:布托啡诺联合丙泊酚和戊乙奎醚用于胃镜检查安全有效,麻醉效果良好,患者意识恢复快,无明显副作用,其中丙泊酚可酌情减量。

Objective：To investigate the clinical application of butorphanol combined with propfol and penehyclidine in gastroscopy.Methods： Ninety patients were randomly divided into three groups（n=30 each） as butorphanol group（Group B） treated by intravenous injection with butorphanol,propfol and penehyclidine,propfol group（Group P） by intravenous injection with propfol and penehyclidine,and control group（Group C） only by surface anesthesia on throat.The changes of blood pressure,heart rate（HR） and the pulse and saturation oxygen（SPO2） in the three groups were observed and compared before operation（T0） and at 1 min（T1）,5 min（T2） and 10 min（T3） after operation.Besides,the side effects,average dosage of propfol and recover time were also observed.Results： The blood pressure of patients at T1 was significantly lower than that at T0 in Group B（P0.05）,but no less than 20% of the basic blood pressure.HR and SPO2 at T1-3 were all in the normal rang（all P0.05）.The blood pressure,HR and SPO2 at T1-3 were all significantly lower than these at T0 in Group P（P0.05）.And blood pressure of 30% patients at T1 was less than 20% of the basic blood pressure.Blood pressure and HR were significantly increased at T1-3 in Group C（P0.05）.In Group B the average dosage was（1.5±0.5）mg/kg,average recover time was（2.5±1.2）min;while the average dosage was（2.1±0.8）mg/kg and average recover time was（6.5±2.5）min in Group P,with significant difference between two groups（P0.05）.Conclusions： Application of butorphanol combined with propfol and penehyclidine is safe and effective in gastroscopy,with better anesthetic effect,quickly-sober consciousness,few side-effects and less dosage of propfol.