盐酸纳布啡复合丙泊酚在成人无痛胃镜检查术中的应用

Application of nalbuphinle hydrochloride combined with propofol during painless gastroscopy for adults

目的探讨盐酸纳布啡复合丙泊酚在成人无痛胃镜检查中的麻醉效果和安全性。方法选取中科大附属第一医院西区18～65岁之间拟行无痛胃镜检查患者120例。采用随机数字表法分为3组,即低、高剂量纳布啡复合丙泊酚麻醉组(N1组,40例; N2组,40例)及芬太尼复合丙泊酚麻醉组(F组,40例)。N1、N2组患者静脉分别注射纳布啡0. 05 mg/kg、0. 10 mg/kg,F组患者静脉注射芬太尼1. 0 ug/kg,三组都复合丙泊酚1. 5mg/kg。三组患者均根据术中出现吞咽反射、呛咳、体动等静脉追加丙泊酚注射液以维持一定的麻醉深度。记录三组患者麻醉诱导前(T0)、睫毛反射消失时(T1)、胃镜刚入食管时(T2)、苏醒时(T3)的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_2),以及三组患者胃镜检查时间、苏醒时间、丙泊酚用量、围术期并发症发生率。结果N1、N2组患者术中低氧血症(T1-T3)的发生率低于F组,差异有统计学意义(P <0. 05);组内比较,三组术中(T1-T3) MAP、HR皆较T0下降,差异有统计学意义; N1、N2组患者苏醒时间显著缩短,差异有统计学意义(P <0. 05); N1、N2组患者围手术期并发症发生率显著低于F组,差异有统计学意义(P <0. 05)。N1丙泊酚用量高于N2组,差异有统计学意义。三组胃镜检查时间差异无统计学意义。结论盐酸纳布啡复合丙泊酚用于成人无痛胃镜检查术具有良好的麻醉效果和安全性。

Objective To analyze the anesthetic effect and safety of nalbuphine hydrochloride combined with Propofol during painless gastroscopy for adults.Methods A total of 120 patients,aged 18-65 years,undergoing painless gastroscopy were randomly divided into 3 groups.Group N1-N2:patients of Low or high-dose nalbuphine hydrochloride(0.05 or 0.1 mg/kg)combined with propofol group(n=40,n=40),Group F:patients of fentanil(1.0μg/kg)combined with propofol group(n=40).All patients were injected intravenously with propofol at the dose of 1.5 mg/kg,and were added a certain of Propofol injection to maintain the depth of ariesthesia according to patients’swallowing reflex、bucking、body movements.MAP,HR and SpO2 before anesthesia(T0),after eyelash reflex disappeared(T1),after placing gastroscopy in esophageal(T2)and when came to senses(T3),and gastroscopy examinational time,awakening time,the total doses of propofol and the incidence of perioperative complications in each group were observed.Results The MAP,HR and SpO2 in each group at T1-T3 were significantly lower than those of T0,and the rates of intraoperative Hypoxemia of in group N1 and N2 were lower than that of group F,both with statistical significances(P<0.05).Awakening time and the incidence of perioperative complications of in group N1 and N2 were lower than those of group F,both with statistical significances(P<0.05).The total doses of propofol in group N1 was higher than that of group N2,with statistical significances(P<0.05).Gastroscopy examinational time in each group had no significant differences(P>0.05).Conclusions Nalbuphine hydrochloride combined with Propofol has better anesthetic effect and safty during painless gastroscopy for adults.