利多卡因复合布托啡诺与丙泊酚在肥胖患者麻醉肠镜检查中的应用效果

Effect of lidocaine combined with butorphanol and propofol on anesthesia colonoscopy in obese patients

目的观察利多卡因复合布托啡诺与丙泊酚在肥胖患者麻醉肠镜检查中的应用效果。方法选择行麻醉肠镜检查的肥胖患者(体质量指数≥30 kg·m-2)160例,采用随机数字表法分为2组(n=80):对照组予布托啡诺联合丙泊酚行静脉麻醉;观察组予利多卡因复合布托啡诺与丙泊酚行静脉麻醉。比较2组丙泊酚用量,麻醉质量(低氧血症、体动反应和术中知晓的发生情况),苏醒质量(苏醒时间,醒时和苏醒后15、30 min VAS评分),肠镜检查时间及术后疲劳综合征(POFS)的发生情况。结果与对照组比较,观察组丙泊酚总用量明显减少[(230.3±40.3)mg vs(324.8±48.4)mg,P <0.01],术中低氧血症发生率降低(18.8%vs 35%,P <0.05),术后苏醒时间缩短[(7±2)min vs (11±3)min,P=0.001],苏醒时和苏醒后15、30 min VAS评分降低,术后POFS发生率降低(14%vs 26%,P=0.048);肠镜检查时间、体动反应、术中知晓发生率差异无统计学意义(P> 0.05)。结论利多卡因复合布托啡诺与丙泊酚可减少肥胖患者麻醉肠镜检查丙泊酚用量,降低术中低氧血症的发生率,提高苏醒质量,减少术后POFS发生率,为肥胖患者提供了安全舒适的麻醉方法。

AIM To explore the efficacy of lidocaine combined with butorphanol and propofol on anesthesia colonoscopy in obese patients. METHODS A total of 160 obese patients with body mass index ≥ 30 kg·m-2 who scheduled for anesthesia colonoscopy were divided into 2 groups using a random number table: the control group(butorphanol combined with propofol) and the observation group(lidocaine combined with butorphanol and propofol). The propofol dosage, anesthesia quality(hypoxaemia, body movement response, and intraoperative awareness), wakeup quality(awakening time, VAS scores at 15 min and 30 min after awakening), the colonoscopy time, and postoperative fatigue syndrome(POFS). RESULTS Compared with the control group, the total dosage of propofol in the observation group was significantly reduced[(230.3±40.3) vs(324.8±48.4), P < 0.001], and the incidence of intraoperative hypoxaemia was reduced(18.8% vs 35%, P=0.020), postoperative awakening time was shortened[(7±2) min vs(11±3) min, P=0.001], VAS scores were decreased at awakening, 15 min and 30 min after recovery, respectively. The incidence of POFS was decreased(14% vs 26%, P=0.048);there was no significant difference in the incidence of colonoscopy, body movement response, and intraoperative awareness(P > 0.05). CONCLUSION Lidocaine combined with butorphanol and propofol can reduce propofol dose, reduce the incidence of intraoperative hypoxemia, improve the quality of recovery, reduce the incidence of postoperative POFS, and provide a safe and comfortable anesthesia method for obese patients during anesthesia colonoscopy.