布托啡诺复合依托咪酯在无痛胃镜检查中的麻醉效果

Anesthetic effect of butorphanol combined with etomidate in painless gastroscopy

目的:探讨布托啡诺复合依托咪酯在无痛胃镜检查中的麻醉效果。方法:行无痛胃镜诊疗术的患者160例随机分组为对照组(n=80)与观察组(n=80);对照组予以芬太尼复合依托咪酯麻醉,观察组予以布托啡诺复合依托咪酯麻醉。记录2组围手术期一般指标;记录2组入室时、意识消失时、退镜结束即刻和检查结束后5 min的平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)和血氧饱和度(blood oxygen saturation,SpO2)。记录2组不良反应发生情况;记录2组患者和医师满意度。结果:与对照组相比,观察组依托咪酯用量显著减少(P<0.05),苏醒时间和复苏室停留时间显著缩短(P<0.05);2组麻醉起效时间、胃镜检查时间对比差异均无统计学意义(均P>0.05)。在意识消失和退镜结束即刻时,2组MAP、HR相比入室时均显著降低(均P<0.05),但观察组高于对照组(P<0.05);2组各时间点SpO2对比差异均无统计学意义(均P>0.05)。与对照组相比,观察组恶心呕吐、呼吸抑制以及肌阵挛发生率均显著降低(均P<0.05)。与对照组相比,观察组患者、麻醉医师及检查医生的满意度均显著提高(均P<0.05)。结论:布托啡诺复合依托咪酯用于无痛胃镜检查安全有效,相比芬太尼复合依托咪酯苏醒快,血流动力学波动小,不良反应少。

Objective:To investigate the anesthetic effect of butorphanol combined with etomidate in painless gastroscopy.Methods:A total of 160 patients undergoing painless gastroscopy were randomly divided into a control group(n=80)and an observation group(n=80).The control group was given fentanyl combined with etomidate anesthesia,and the observation group was given butorphanol combined with etomidate anesthesia.The perioperative general indexes of the 2 groups were recorded;the mean arterial pressure(MAP),heart rate(HR),and blood oxygen saturation(SpO2)of the 2 groups were recorded at the time of entering the room,the loss of consciousness,the end of the withdrawal and 5 min after the end of the examination.The occurrence of adverse reactions in the 2 groups was recorded.The satisfaction of patients and physicians in the 2 groups was recorded.Results:Compared with the control group,the dosage of etomidate in the observation group was significantly reduced(P<0.05),and the recovery time and recovery room stay time were significantly shortened(both P<0.05).No significant difference was found in the onset time of anesthesia and gastroscopy time between the 2 groups(both P>0.05).At the time of loss of consciousness and the end of withdrawal,the MAP and HR of the 2 groups were significantly lower than those when entering the room(all P<0.05),but the observation group was higher than the control group(P<0.05).No significant difference was found in SpO2 between the 2 groups at each time point(P>0.05).Compared with the control group,the incidence of nausea and vomiting,respiratory depression and myoclonus in the observation group were significantly lower(all P<0.05).Compared with the control group,the satisfaction of patients,anesthesiologists and examiners in the observation group were significantly improved(all P<0.05).Conclusion:Butorphanol combined with etomidate is safe and effective for painless gastroscopy.Compared with fentanyl combined with etomidate,it has a faster recovery,less hemodynamic fluctuations,and less adverse reactions.