布托啡诺经鼻腔给药和静脉注射用于无痛肠镜的效果比较

Effect comparison of butorphanol on painless colonoscopy by nasal delivery and intravenous injection

目的比较布托啡诺经鼻腔给药和静脉注射用于无痛肠镜检查的效果。方法行无痛肠镜检查的患者90例,随机分为A组和B组各45例,A组经鼻滴入布托啡诺,B组静脉注射布托啡诺。比较2组用药前(T0)、用药后1min(T1)、静脉注射丙泊酚后1min(T2)、2min(T3)、3min(T4)、4min(T5)、术毕(T6)、清醒(T7)时的MAP、HR、SpO2以及诱导时间、苏醒时间、检查持续时间、OAA/S、肢动情况、丙泊酚总量、麻醉效果。结果 2组MAP、HR在T1～T7较T0低,差异有统计学意义(P<0.05),而组间比较差异无统计学意义(P>0.05)。2组SpO2在T2～T6较T0、T1、T7低,差异有统计学意义(P<0.05),且A组高于B组(P<0.05)。2组诱导时间、苏醒时间、检查持续时间、术中镇静评分(OAA/S)、丙泊酚总量比较差异无统计学意义(P>0.05)。2组均无肢动情况。A组麻醉效果优于B组,差异有统计学意义(P<0.05),A组术者满意度明显高于B组,差异有统计学意义(P<0.05)。2组患者舒适度差异无统计学意义(P>0.05)。结论布托啡诺经鼻腔给药用于无痛肠镜检查效果优于静脉注射。

Objective To compare the effects of butorphanol on painless colonoscopy by nasal delivery and intravenous injection.Methods 90 patients were randomly divided into group A and group B,45 cases of each.The group A were given butorphanol by endonasal approach,and the group B were given butorphanol by intravenous injection.Compare the MAP,HR and SpO2 of 2 groups an premedication（T0）,1 min after medication（T1） and 1min（T2）,2min（T3）,3min（T4）,4min（T5） after intravenous propofol,and the end of operation（T6）,awake（T7）,and the induction time,recovery time,the duration time of colonoscopy,Observer＇s Assessment of Alertness/Sedation Scale（OAA/S）,movement condition,total amount of propofol and the effect of anesthesia.Results The MAP and HR of 2 groups at T1～T7 were lower than those at T0,and the differences were statistically significant（P0.05）.But the differences of 2 groups were of no statistically significant（P0.05）.The SpO2 of 2 groups at T2～T6 were lower than that at T0、T1、T7,and the differences were statistically significant（P0.05）,and the SpO2 at T2～T6 of group A were higher than that of group B,the differences were statistically significant（P0.05）.There were no statistical significance between the induction time,recovery time,the duration time of colonoscopy,OAA/S,movement condition and total amount of propofol of 2 groups（P0.05）.There was no movement condition in 2 group.The effect of anesthesia of group A was better than that of group B,and the difference was statistically significant（P0.05）.The satisfaction degree of group A was higher than that of group B,and the difference was statistically significant（P0.05）.There was no statistical significance between comfort degree of 2 groups（P0.05）.Conclusion It is more safe and effective to use butorphanol by intranasal administration than by intravenous injection in patients of painless colonoscopy.