ED95布托啡诺在无痛胃肠道内镜检查中作用探讨  

Observation on the role of ED95 Butorphanol in painless gastrointestinal endoscopy

作　　者：邱增亮 宋秀玲 林喻月 孙东东 QIU Zeng-liang;SONG Xiu-ling;LIN Yu-yue;SUN Dong-dong(Department of Pharmacy,Kaifeng People's Hospital,Kaifeng 475000,China)

机构地区：[1]开封市人民医院药剂科,河南开封475000

出　　处：《社区医学杂志》2022年第14期798-802,共5页Journal Of Community Medicine

摘　　要：目的分析ED95布托啡诺与舒芬太尼应用于无痛胃肠道内镜检查中的作用。方法收集2019-05-31-2020-07-31开封市人民医院124例行无痛胃肠道内镜检查患者的临床资料。根据麻醉方式不同,分为A组61例(ED95布托啡诺)和B组63例(舒芬太尼)。检查前30min肌内注射阿托品0.5mg,患者进入手术后建立静脉通路,并监测患者心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SpO_(2)),使用面罩吸氧,准备麻醉剂以及相关急救物品。A组患者静脉推注ED95布托啡诺(1mg),B组静脉推注舒芬太尼(0.05mg),之后2组患者均静脉推注丙泊酚l~2mg/kg,至患者睫毛反射消失呼之不应,即可将内镜置入。在手术中以术中维持2~4mg/(kg·h)的速率使用输液泵推注丙泊酚,根据患者的HR、血压、体动反射情况对丙泊酚注射速度进行调整,以此维持麻醉深度。患者SpO_(2)<90%时,需要给予密闭面罩加压给氧,检查结束后可送至恢复室恢复。记录患者给药前(T_(0))、给药后2min(T_(1))、内镜置入时(T_(2))、内镜退出时(T_(3))HR、MAP和SpO_(2),观察苏醒时间、疲劳程度评分、检查时间、丙泊酚使用情况,评估停药后不同时间段Ramsay评分以及不良反应发生率。结果2组患者HR和MAP变化比较,不同时间段差异有统计学意义(HR:F_(时间)=5.965,P_(时间)=0.001;MAP:F_(时间)=84.032,P_(时间)<0.001),组间比较差异无统计学意义,时间和组间无交互作用,均P>0.05。2组患者SpO_(2)不同时间段(F_(时间)=299.709,P_(时间)<0.001)、组间(F_(组间)=38.811,P_(组间)<0.001)比较,差异均有统计学意义,SpO_(2)值和时间存在相互效应(F_(交互)=41.941,P_(交互)<0.001)。2组患者丙泊酚使用情况、检查时间、疲劳程度评分比较差异均无统计学意义,均P>0.05。A组苏醒时间为(6.56±1.55)min,长于B组的(5.18±1.36)min,t=5.274,P<0.05。停药5、10、20、25min时,A组Ramsay评分分别为(5.62±0.24)、(3.69±0.71)、(2.62±0.58)和(2.35±0.57)分,B组�Objective To analyze the effect of ED95 butorphanol and sufentanil in painless gastrointestinal endoscopy.Methods A total of 124 patients who underwent painless gastrointestinal endoscopy in our hospital from May 31,2019 to July 31,2020 were collected,according to different anesthesia methods,they were divided into 61 cases in group A(ED95butorphanol)and 63 cases in group B(sufentanil).Atropine 0.5mg was injected intramuscularly 30minutes before the examination,after the patient entered the operation,venous access was established,and the patient’s heart rate(HR),mean arterial pressure(MAP),and pulse oxygen saturation(SpO_(2))were monitored,used a mask to inhale oxygen and prepared for anesthesia and related first aid items.The group A was given intravenous injection of ED95butorphanol(1mg),and group B was given intravenous injection of sufentanil(0.05mg),both groups were given intravenous injection of propofol 1-2mg/kg until the eyelash reflex disappeared,if not,the endoscope could be inserted.During the operation,the infusion pump was used to inject propofol at a rate of 2-4mg/(kg·h),the injection speed of propofol was adjusted according to the patient’s HR,blood pressure,and body movement reflex to maintain the depth of anesthesia.When the patient’s SpO_(2)was less than 90%,a closed mask needed to be given pressurized oxygen,and it could be sent to the recovery room for recovery after the examination.Intraoperative HR,MAP,SpO_(2),recovery time,fatigue score,examination time,propofol usage.Ramsay score and adverse reaction rate at different time periods after drug withdrawal were recorded.Results There were statistically significant differences in HR and MAP changes between the two groups at different time periods(F_(HR time)=5.965,P=0.001;F_(MAP time)=84.032,P<0.001),there was no difference between the groups,and there was no interaction between time and groups(P>0.05).There were statistically significant differences in SpO_(2)between the two groups at different time periods and between groups,and there

关 键 词：ED95布托啡诺 舒芬太尼 无痛胃肠道内镜 麻醉 呼吸抑制 

分 类 号：R614[医药卫生—麻醉学]