喷他佐辛复合丙泊酚静脉麻醉用于经内窥镜逆行胰胆管造影的临床观察  

Clinical Observation of the Application of Pentazocine Combined with Propofol Anesthesia in ERCP

作　　者：杨烨 李雯[2] 曹莹[2] 韩明[3] 王旭浩[3] 

机构地区：[1]贵州省骨科医院麻醉科,贵阳550007 [2]贵阳医学院附属医院麻醉科,贵阳550004 [3]贵阳医学院附属医院肝胆外科,贵阳550004

出　　处：《中国药房》2013年第28期2646-2648,共3页China Pharmacy

摘　　要：目的:观察喷他佐辛复合丙泊酚用于经内窥镜逆行胰胆管造影(ERCP)的麻醉效果。方法:将100例拟行ERCP的患者随机均分为5组。C组患者采用芬太尼1μg/kg静脉注射;P组(包括P1-4组)患者分别采用喷他佐辛0.4、0.6、0.8、1.0 mg/kg静脉注射。所有患者均用丙泊酚1.0～1.5 mg/kg静脉注射诱导麻醉,丙泊酚3～6 mg(/kg.h)静脉泵注维持麻醉。观察比较各组患者的麻醉效果、术中体动、呼吸循环抑制、术后疼痛评分和不良反应情况等,并记录各组丙泊酚使用量、患者停药至睁眼时间、定向力恢复时间等。结果:P2、P3、P4组患者的麻醉效果显著优于其余各组,但P2、P3组患者术中不良事件最少,患者停药至睁眼时间及定向力恢复时间P4组最长(P<0.05);丙泊酚诱导剂量及总剂量C组最大(P<0.05)。术后疼痛VAS评分P1-4组显著低于C组(P<0.05)。麻醉诱导时间、术中知晓、术后不良反应等情况各组间差异无统计学意义(P>0.05)。结论:0.6～0.8 mg/kg喷他佐辛复合丙泊酚用于ERCP麻醉效果更佳,并能减少患者术中不良事件,减轻术后疼痛,减少丙泊酚用量。OBJECTIVE： To investigate the anaesthetic effect of pentazocine combined with propofol anesthesia in ERCE METHODS： 100 patients undergoing ERCP were randomly assigned to 5 groups. Group C was given fentanyl 1 μg/kg; group P （group PH） was given pentazocine 0.4, 0.6, 0.8, 1.0 mg/kg. Each group was induced by intravenous injection of propofol 1.0-1.5 mg/kg, followed by pumping 3-6 mg/（kg, h）. Anaesthetic effect, intraoperative vital signs, respiratory cycle inhibition, VAS score, postoperative nausea, vomiting and other ADRs were all observed, and the dose of propofol, the time needed for awaken- ing, directive force recovery time, etc. were all recorded. RESULTS： The anaesthetic effects of group P2, P3 and P4 were better than others, but the adverse events of group P2 and P3 was less than other groups; the time needed for awakening of group P4 was the longest, and the dose of propofol in group C was the largest. There was statistical significance （P〈0.05）. VAS score of group PH was lower than group C （P〈0.05）. Anesthesia induction time, surgeny knowing, ADRs was no statistical significance （P〉 0.05）. CONCLUSIONS： Pentazocine 0.6-0.8 mg/kg combined with propofol is optimal scheme for anesthesia during ERCP, and can reduce adverse events, relieve postoperative pail and decrease the dose of propofol.

关 键 词：喷他佐辛 丙泊酚 经内窥镜逆行胰胆管造影 临床观察 剂量 

分 类 号：R576[医药卫生—消化系统]