纳布啡在无痛胃肠镜检查中减轻丙泊酚静脉注射痛的效果

Effect of nalbuphine on alleviating intravenous injection pain caused by propofol during painless gastrointestinal endoscopy

摘要:

目的 评价纳布啡在无痛胃肠镜检查中减轻丙泊酚静脉注射痛的效果。方法 选择于该院住院，择期行无痛胃肠镜检查的患者100例。其中，男54例，女46例，年龄20～65岁，体重指数（BMI）19～26 kg/m²，美国麻醉医师协会（ASA）分级为Ⅰ级或Ⅱ级，采用随机数表法将患者分为纳布啡复合丙泊酚组（N组，n = 50）和对照组（C组，n = 50）。N组静脉注射纳布啡0.15 mg/kg，C组静脉注射等容量生理盐水，3 min后两组均静脉推注丙泊酚1.50～2.00 mg/kg，待患者睫毛反射消失后行胃肠镜检查，根据患者吞咽反射及体动情况，酌情追加丙泊酚0.50～1.00 mg/kg。比较两组患者丙泊酚注射痛发生率、不同部位丙泊酚注射痛发生率、丙泊酚注射痛的严重程度、苏醒时间、检查时间、丙泊酚用量和相关不良反应发生情况。结果 N组丙泊酚注射痛发生率、手背处静脉注射痛发生率和丙泊酚静脉注射后轻、中度疼痛所占比例均明显低于C组（P < 0.05）；N组苏醒时间短于C组，丙泊酚用量少于C组（P < 0.05）。N组出现1例恶心呕吐，C组出现1例心动过缓。两组均未发生反流误吸、低氧血症、低血压及血栓性静脉炎等不良反应。结论 纳布啡0.15 mg/kg预处理，可以减轻丙泊酚静脉注射引起的疼痛，复合丙泊酚用于无痛胃肠镜检查，可缩短苏醒时间，减少丙泊酚用量，安全有效。

Abstract:

Objective To evaluate the effect of nalbuphine on alleviating intravenous injection pain caused by propofol during painless gastrointestinal endoscopy.Methods 100 patients (54 males and 46 females) who were selectively hospitalized and underwent painless gastrointestinal endoscopy were chosen, with the age from 20 to 65 years, the body mass index (BMI) from 19 to 26 kg/m², and the American Society of Anesthesiologists (ASA) grade Ⅰ or Ⅱ. According to the random number table, they were divided into two groups, namely naborphine combined with propofol group (group N) and control group (group C), with 50 cases in each group. 0.15 mg/kg nalbuphine was injected intravenously in group N, while the same volume of normal saline was injected intravenously in group C. After 3 min, intravenous injection of 1.50 ~ 2.00 mg/kg propofol was given for both groups, and gastrointestinal endoscopy was performed after loss of eyelash reflexes. 0.50 ~ 1.00 mg/kg propofol could be added appropriately in accordance with the patients’ swallowing reflexes and body motion conditions. The incidence of propofol-induced injection pain, the incidence of propofol-induced injection pain at different body parts, the severity of propofol-induced injection pain, recovery time, inspection time, propofol dosage, and the occurence of relevant adverse reactions were compared between the two groups.Results The proportions of the incidence of propofol-induced injection pain, the incidence of intravenous injection pain at the back of the hand, and mild to moderate pain after intravenous injection of propofol in group N were all significantly lower than those in group C (P < 0.05). The recovery time in group N was shorter than that in group C, the propofol dosage in group N was less than that in group C (P < 0.05). One case in group N had nausea and vomiting, and one case in group C had bradycardia. Adverse reactions such as aspiration, hypoxemia, hypotension, and thrombophlebitis did not occur in both groups.Conclusion Pretreatment with 0.15 mg/kg nalbuphine can alleviate the pain caused by intravenous injection of propofol, and naborphine combined with propofol can shorten recovery time and reduce propofol dosage in painless gastrointestinal endoscopy, so it is safe and effective.