地佐辛复合丙泊酚对无痛小肠镜检查患者血流动力学及麻醉深度的影响  

Effects of dezocine combined with propofol on hemodynamics and anaesthetic depth in patients undergoing painless enteroscopy

作　　者：刘红[1] 吉锦泉[1] 于冬男[1] 王志鹏[1] 孙柯[1] 

机构地区：[1]广东省医学科学院广东省人民医院麻醉科,广州510080

出　　处：《中华实用诊断与治疗杂志》2013年第11期1061-1063,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：广东省科技计划资助项目(2010B031600160)

摘　　要：目的探讨地佐辛复合低剂量丙泊酚用于无痛小肠镜检查对患者血流动力学及麻醉深度的影响。方法行无痛小肠镜检查患者70例随机分成观察组和对照组各35例,观察组依次缓慢静脉注射地佐辛50μg/kg、丙泊酚1mg/kg,对照组静脉注射丙泊酚2mg/kg,检查中如有体动反应则追加丙泊酚0.2～0.5mg/kg。观察2组给药前(T0)、给药后5min(T1)、给药后10min(T2)、给药后30min(T3)、给药后60min(T4)、检查结束出镜时(T5)心率、平均动脉压(mean artery pressure,MAP)、血氧饱和度(pulse oxygen saturation,SpO2)和麻醉深度指数(Narcotrend,NTI)以及丙泊酚用量、苏醒时间及不良反应发生情况。结果 2组T1～T5时间点MAP均低于T0时(P<0.05),对照组T1时SpO2低于观察组(P<0.05);观察组丙泊酚用量和苏醒时间低于对照组(P<0.05),T1～T5时间点NTI均高于对照组和T0时(P<0.05),心动过速、呼吸抑制、Ⅲ级体动反应和术后腹痛、腹胀发生率低于对照组((P<0.05)。结论 无痛小肠镜检查中应用地佐辛复合丙泊酚较单独应用丙泊酚镇痛效果好,血流动力学稳定,并可减少丙泊酚用量。Objective To investigate the effects of dezocine combined with propofol on hemodynamics and anaesthetic depth in patients undergoing painless enteroscopy. Methods Seventy patients undergoing painless enteroscopy were randomly divided into observation group and control group, with 35 patients in each group. Observation group was intravenously injected dezocine 50 μg/kg followed by propofol 1 mg/kg and propofol 2 mg/kg slowly. Control group was intravenously injected propofol 2 mg/kg, and was added propofol 0.2 to 0.5 rag/ kg if there was any body movement during enteroscopy. The heart rate, mean artery pressure, pulse oxygen saturation （SpO2）, Narcotrend, the consumed dose of propofol, full recovery time and the adverse reaction were observed and recorded at different time points including before anesthesia （To）, five minutes after anesthesia （T1）, 10 minutes after anesthesia （T2）, 30 minutes after anesthesia （T3）, 60 minutes after anesthesia （T4） and after withdrawing enteroscope （T5）. Results The mean artery pressure was lower at T1 to T5 than that at To in both groups （P〈0.05）, and SpO2 was lower at T1 in control group than that in observation group （P〈0.05）. The consumed dose of propofol and full recovery time were lower in observation group than those in control group （P〈0.05）. Narcotrend was higher at T1 to T5 in observation group than that in control group and than that at To （P〈0.05）. The incidences of tachycardia, respiratory depression, the body movement in degree Ⅲ and postoperative abdominal pain were lower in observation group than those in control group （P〈0.05）. Conclusion The combined use of Dezocine and propofol is more effective for sedation than the use of Dezocine alone in painless enteroscopy with stable hemodynamics. The dosage of Dezocine can be reduced.

关 键 词：小肠镜检查 无痛 地佐辛 丙泊酚 

分 类 号：R614[医药卫生—麻醉学]