纳美芬在舒芬太尼复合丙泊酚无痛胃镜检查中的应用

目的探讨纳美芬用于舒芬太尼复合丙泊酚无痛胃镜检查中的效果及其对呼吸、循环的影响。方法选择接受无痛胃镜手术患者120例，随机分为A、B两组，各60例：A组予舒芬太尼0．2μg／kg后复合丙泊酚2mg／kg静脉注射；B组麻醉前静注纳美芬02μg／kg后予舒芬太尼0．2μg／kg复合丙泊酚2mg／kg静脉注射。比较两组患者意识消失时间、睁眼时间、恢复定向力时间、丙泊酚用量；观察两组不同时间点BP、HR、RF、SpO2、以及体动反应、呼吸抑制、发生面罩给氧的例数和术后呕心呕吐的例数。结果两组患者意识消失时间和丙泊酚用量，差异无统计学意义（P〉005），对两组各时间点HR、SpO2影响不明显，二者差异无统计学意义（P〉0．05）；睁眼时间和定向力恢复时间B组短于A组，两者差异有统计学意义（P〈0．05）。B组RR、MAP优于A组，差异有统计学意义（P〈0．05）。结论0．2μg／kg纳美芬在舒芬太尼复合丙泊酚无痛胃镜检查中可有效拮抗舒芬太尼引起的呼吸抑制、缩短苏醒时间，有利于循环稳定且不良反应少。

Objective To investigate the efficacy of nalmefene in the painless gastroscopy of sufentanil combined with propofol and its effects on respiration and circulation. Methods 120 patients who underwent painless gastroscopy were randomly divided into A and B groups, 60 in each group. Group A was given sufentanil 0.2 μ g/kg and then combined with propofol 2mg/kg intravenously. Group B was given intravenous nalmefene 0.2 μ g/kg before anesthesia. Sufentanil 0.2 μ g/kg combined with propofol 2mg /kg intravenous injection. The disappearance time of consciousness, blinking, restoring orientation, and the amount of propofol were compared between the two groups. The BP, HR, RF, SpO2 were observed at different time in the two groups, and the number of body motion response, respiratory depression, mask oxygen inhalation, postoperative nassea and vomiting were observed. Results No significant difference in the time of consciousness disappears and the amount of propofol was found in the two groups （ P〉0.05 ） . No significant difference in HR and SpO2 was found between the two groups at each time, and the difference was not statistically significant （ P〉0.05 ） . The RR and MAP of group B were better than that of group A, and the difference was statistically significant （ P〈0.05 ） . Conclusion 0.2 p, g/kg nalmefene can effectively antagonize the respiratory depression caused by sufentanil and shorten the recovery time, which is beneficial to the stability of circulation and less adverse reactions in the painless gastroscopy of sufentanil combined with propofol.