丙泊酚复合纳布啡应用于膀胱镜拔除双J管日间手术中的效果观察

The effect of propofol combined with nalorphine in the removal of double-J tube by cystoscope during daytime operation

目的观察丙泊酚复合纳布啡应用于膀胱镜拔除双J管日间手术中的效果。方法选择2018年1月至2018年12月本院择期拟行无痛膀胱镜拔除双J管的日间手术患者40例,ASA分级Ⅰ-Ⅱ级,年龄18~60岁,采用随机数字表法分为丙泊酚复合盐酸纳布啡(A)组和丙泊酚复合舒芬太尼(B)组,每组20例。A组:先用0.15 mg/kg静脉缓慢注射盐酸纳布啡,3 min后慢推丙泊酚1~2mg/kg;B组:先用0.1μg/kg静脉缓慢注射舒芬太尼,3min慢推丙泊酚1~2 mg/kg。各组根据皱眉、体动等表现追加丙泊酚,其维持量0.3 mg/kg,至手术结束。观察记录麻醉前(T0)、麻醉后(T1)、术中(T2)、术后(T3)时间点的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)、呼吸抑制、体动次数。记录患者术中呛咳和术后恶心呕吐等不良反应。记录患者的手术时间、苏醒时间(从手术结束至呼唤姓名可使之睁眼)以及苏醒时、术后1h和术后2h患者的视觉模拟评分(VAS)。结果丙泊酚复合纳布啡呼吸抑制轻,术中体动、术后恶心呕吐发生率低,术后1 h和术后2 h的VAS评分显著降低(P<0.05)。结论丙泊酚复合盐酸纳布啡用于膀胱镜拔除双J管日间手术的镇痛效果好,安全性高。

Objective To observe the effect of propofol combined with nabufen in the day op-eration of cystoscopy with double-J tube extraction.Methods Forty patients(ASA grade Ⅰ-Ⅱ,aged 18-60 years)scheduled to undergo painless cystoscopy for double-J tube removal were randomly divid-ed into two groups:propofol combined with nabuphine hydrochloride(A)group and propofol combined with sufentanil(B)group,with 20 cases in each group.In group A,Nabufen hydrochloride was slowly injected intravenously with 0.15 mg/kg,then propofol was slowly pushed 1-2 mg/kg after 3 mi-nutes.In group B,sufentanil was slowly injected intravenously with 0.1μg/kg,then propofol was slowly pushed 1-2 mg/kg after 3 minutes.The propofol maintenance dose was 0.3 mg/kg in each group according to frown and physical performance until the end of operation.MAP,HR,SpO2,re-spiratory depression and number of body movements were observed and recorded before anesthesia(TO),after anesthesia(T1),during operation(T2)and after operation(T3).Adverse reactions such as cough during operation and nausea and vomiting after operation were recorded.The time of op-eration,the time of awakening(from the end of operation to the name of the patient can open his eyes)and the visual analogue scale(VAS)of the patients at the time of awakening,1 hour after operation and 2 hours after operation were recorded.Results The incidence of nausea and vomiting during and after operation was low.The VAS scores at 1 hour and 2 hours after operation were significantly de-creased(P<0.05).Conclusions The analgesic effect and safety of propofol combined with nabu-phine hydrochloride in the day operation of cystoscopy with double-J tube removal are good.