布托啡诺复合丙泊酚用于无痛胃肠镜诊疗的临床效果评价

Application evaluation of butorphanol combined with propofol in painless gastrointestinal endoscopy

摘要:

目的 探讨布托啡诺复合丙泊酚用于无痛胃肠镜诊疗的临床效果。方法 选取拟择期行无痛胃肠镜诊疗的患者250例，随机分为布托啡诺复合丙泊酚组（B组）和舒芬太尼复合丙泊酚组（S组），每组125例。麻醉诱导前，B组静脉注射布托啡诺7.5 μg/kg，S组静脉注射舒芬太尼0.1 μg/kg，5 min后，两组均缓慢静注丙泊酚1.5～2.0 mg/kg进行麻醉诱导，术中静脉泵注丙泊酚4.0～6.0 mg/（kg·h）进行麻醉维持。记录术中体动等镇静相关不良事件、丙泊酚用量、苏醒时间、离院时间和术后舒适度。结果 B组术中体动、呛咳、呼吸抑制、丙泊酚注射痛和术后恶心呕吐等发生率明显低于S组，丙泊酚注射痛严重程度明显轻于S组，术后腹部疼痛评分明显低于S组，差异均有统计学意义（P < 0.05）。两组患者丙泊酚用量、呃逆发生率、苏醒时间、离院时间、术后疲劳视觉模拟评分（VAS）、低血压、心动过缓、眩晕和嗜睡等发生率比较，差异均无统计学意义（P > 0.05）。结论 布托啡诺复合丙泊酚方案应用于无痛胃肠镜诊疗，可提高镇静、镇痛效果，降低不良反应发生率。值得临床推广应用。

Abstract:

Objective To explore the effects of butorphanol combined with propofol in painless gastrointestinal endoscopy.Methods 250 patients who underwent painless gastrointestinal endoscopy were selected and randomly divided into two groups: butorphanol combined with propofol group (group B) and sufentanil combined with propofol group (group S), with 125 patients in each group. Before anesthesia induction, butorphanol 7.5 μg/kg was injected intravenously in group B, while sufentanil 0.1 μg/kg was injected intravenously in group S. Give 5 min onset time, propofol 1.5 ~ 2.0 mg/kg was administrated intravenously in both groups, followed by a continuous intravenous infusion at a rate of 4.0 ~ 6.0 mg/(kg·h) during the endoscopy. The incidence of body movement and other sedation-related adverse events, the cumulative dosage of propofol, recovery time, departure time, and postoperative comfort evaluation were recorded.Results The incidence of body movement, cough, respiratory depression, propofol injection pain, postoperative nausea and vomiting in group B were lower than those in group S, the degree of propofol injection pain in group B was milder than that in group S, and the postoperative abdominal pain score in group B was lower than that in group S, the differences were statistically significant (P < 0.05). There were no statistically significant differences in the cumulative dosage of propofol, the incidence of hiccup, recovery time, departure time, visual analogue scale (VAS) of postoperative fatigue degree and the incidence of hypotension, bradycardia, dizziness, drowsiness between the two groups (P > 0.05).Conclusion Butorphanol combined with propofol can improve the sedation and analgesia effect in painless gastrointestinal endoscopy, and reduce the adverse reactions. It is worthy of clinical application.