小剂量纳洛酮应用于无痛胃镜78例疗效观察  

作　　者：任学云[1] 白飞虎[1] 陈学新[2] 

机构地区：[1]宁夏医科大学附属医院消化内科,750004 [2]宁夏医科大学附属医院麻醉科

出　　处：《当代医学》2010年第32期1-2,共2页Contemporary Medicine

基　　金：宁夏医科大学特殊人才科研启动项目(2007);宁夏回族自治区卫生厅重点项目(2008);宁夏回族自治区教育厅重点项目(2008)

摘　　要：目的探讨小剂量纳洛酮应用于无痛胃镜检查的临床效果。方法无痛胃镜检查的患者140例,随机分成纳洛酮组(78例)即静推芬太尼0.001～0.003mg/kg、丙泊酚1～3mg/kg,检查结束时静推纳洛酮2μg/kg;对照组(62例)即静推芬太尼0.001～0.003mg/kg、丙泊酚1～3mg/kg。麻醉过程中观察麻醉后体温、血压、心率、呼吸、血氧饱和度、麻醉起效时间,观察术后清醒时间,疼痛评分以及呼吸暂停、术中呛咳、肌阵挛、抽搐等发生率。结果纳洛酮组在麻醉起效时间、心率变化、呼吸、血氧饱和度等指标上与对照组相比无显著性差异(P<0.05)。纳洛酮组麻醉清醒时间为(3.3±0.4)min、呼吸暂停(24±2.7)%、肌阵挛(1.3±0.2)%、呛咳(2.6±0.3)%,以上指标均显著少于对照组(P<0.05)。疼痛评分纳洛酮组高于对照组(P<0.05)。结论小剂量纳洛酮可显著增强无痛胃镜检查的安全性,为临床无痛胃镜检查提供更为安全可靠的用药指导方案。Objective To evaluate clinical efficacy of low dose diazepam in painless gastroscopy. Methods Seventy eight patients undergoing painless gastroscopy at our hospital were randomly divided into two groups. 2μg/kg im. of naloxone in combination with propofol（2mg/kg） and fentanyl（2μg/kg） was administrated in experimental group （n =78 cases）, while propofol（2mg/kg） and fentanyl（2μg/kg） were administrated in control group（n = 62 cases）. Indicators such as body temperature, blood pressure, heart rate, breath, saturation of blood oxygen, onset time of anesthesia, consciousness time after anesthesia, and side effects such as incidence of choking breathing holding, bucking in operation, myoclonia, hyperspasmia, and apnea rate were detected during anesthesia,and Visual analogue scale（VAS）and （Emotional scale ES） Results No significant differences were found between experimental group and control group in reaction time of anesthesia, heart rate, breath, saturation of blood oxygen during operation （P0.05）. And items such as regaining consciousness time（3.3±0.4）min, apnea rate（24±2.7）%, myoclonia rate（1.3±0.2）%,bucking rate（2.6±0.3）% in experimental group were significantly lower as compared to control group（P0.05） .VAS and ES in experimental group significantly higher than controls. Conclusion Low dose naloxone in combination with propofol and fentanyl is of high safety, and supply with a reliable and safety guide for anesthesia in painless gastroscopy.

关 键 词：小剂量 纳洛酮 无痛胃镜 麻醉苏醒 疼痛 

分 类 号：R614[医药卫生—麻醉学] R573[医药卫生—外科学]