摘要
目的探讨环泊酚复合纳布啡对老年无痛胃肠镜诊断和治疗中的麻醉效果。方法选取2021年5-12月在民航总医院拟行无痛胃肠镜诊疗(活检和息肉切除)的老年患者共121例,按照随机数字表法分为环泊酚复合纳布啡组(A组,61例)和丙泊酚复合纳布啡组(B组,60例)。两组均以相同药物剂量(纳布啡:0.1 mg/kg;丙泊酚或环泊酚:0.12~0.16 ml/kg)及推注速度进行麻醉诱导,待受试者改良警觉/镇静评分(MOAAS)≤1开始胃肠镜诊疗。观察两组快速诱导时间、苏醒时间、药物追加次数及总追加量、药物总量、恢复室停留时间及不良反应(注射痛、进镜反应、低心率、低血压、呼吸抑制、恶心呕吐)发生率。结果两组均无诊疗失败病例;两组快速诱导时间、诱导剂量、药物追加次数及总追加量、苏醒时间、恢复室停留时间差异均无统计学意义。两组间心率、平均动脉压、脉搏氧饱和度总体差异无统计学意义,呈时间变化趋势,且不存在时间与组别的交互作用(F=1.946,P>0.05;F=0.980,P>0.05;F=1.586,P>0.05);与B组比较,A组注射痛、进镜反应、低血压、心动过缓、呼吸抑制发生率明显降低,差异有统计学意义(P<0.05);两组恶心呕吐发生率比较,差异无统计学意义。结论环泊酚复合纳布啡用于老年无痛胃肠镜,与丙泊酚复合纳布啡的麻醉效果相当;但注射痛、进镜反应、呼吸抑制、低血压、心动过缓等不良反应的发生率低。
Objective To study the applicability of ciprofol combined with nalbuphine in painless gastroenteroscopy on elderly patients.Methods A total of 121 elderly patients who were scheduled to undergo painless gastroscopic diagnosis and treatment(including biopsy and polypectomy)in the Civil Aviation General Hospital from May 2021 to December 2021 were selected and randomly divided into two groups:ciprofol combined with nalbuphine(group A,61 cases),and propofol combined with nalbuphine(group B,60 cases).The patients in the two groups were treated at the same dose(nalbuphine:0.1 mg/kg,propofol or ciprofol:0.12-0.16 ml/kg)and at the same speed for anesthesia induction.After‘Modified Observer’s Assessment of Alertness/Sedation Scale(MOAAS)of the subjects≤1,the diagnosis and treatment procedure of bidirectional endoscopy was started.The rapid in-duction time,awaken time,induced dose,number of drug additions and additional doses,total dosage,post anesthesia care time and adverse events(injection pain,entry cough reaction,low heart rate,hypotension,respiratory depression,nausea and vomiting)were observed in the two groups.Results There were no cases of diagnosis and treatment failure in both groups,with no significant difference between the two groups in rapid induction time,number and dose of drug addition,total drug dosage,and post anesthesia care time.No statistically significant changes in variation tendency of heart rate,mean arterial pressure and pulse oxygen saturation between the two groups,showing a time change trend(F=66.700,P<0.05;F=64.708,P<0.05;F=15.634,P<0.05),with no interaction between times and groups(F=1.946,P>0.05;F=0.980,P>0.05;F=1.586,P>0.05).Compared with group B,the incidence of injection pain,entry cough reaction,hypotension,bradycardia and respiratory depression in group A were significantly reduced(P<0.05).There was no significant difference in the incidence of nausea and vomiting between the two groups(P>0.05).Conclusions The effect of ciprofol combined with nalbuphine in elderly patients with painless gastroenteroscopy is comparable to that of propofol combined with nalbuphine.However,the incidence of adverse reactions,such as injection pain,entry cough reaction,respiratory depression,hypotension and bradycardia,was lower.
作者
高子雯
周日华
李家新
王楠
GAO Ziwen;ZHOU Rihua;LI Jiaxin;WANG Nan(Department of Anesthesiology,Civil Aviation General Hospital,Beijing 100123,China)
出处
《武警医学》
CAS
2023年第4期330-334,共5页
Medical Journal of the Chinese People's Armed Police Force
基金
北京康盟慈善基金会医学科研发展基金项目(S054)
关键词
环泊酚
纳布啡
无痛胃肠镜
老年
麻醉
ciprofol
Nalbuphine
painless gastroenteroscopy
the aged
anesthesia
