羟考酮或氢吗啡酮复合异丙酚麻醉用于结肠镜诊疗术的效果  

Efficacy of oxycodone or hydromorphone combined with propofol for colonoscopy

作　　者：陈莹莹[1] 张宗泽[1] 刘汉兴[2] 陈畅[1] 周凌雪[1] 王焱林[1] 

机构地区：[1]武汉大学中南医院麻醉科,430071 [2]武汉大学中南医院神经内科,430071

出　　处：《中华麻醉学杂志》2015年第6期724-726,共3页Chinese Journal of Anesthesiology

基　　金：湖北省自然科学基金（2014CFA046）

摘　　要：目的 评价羟考酮或氢吗啡酮复合异丙酚麻醉用于结肠镜诊疗术的效果.方法 选择结肠镜诊疗术患者150例,ASA分级Ⅰ或Ⅱ级,性别不限,年龄18 ～ 64岁,体重45 ～ 85 kg.采用随机数字表法,将其分为3组（n=50）：芬太尼复合异丙酚组（F组）、羟考酮复合异丙酚组（O组）和氢吗啡酮复合异丙酚组（H组）.3组分别经60 s静脉注射芬太尼1μg/kg（F组）、羟考酮0.1 mg/kg（O组）、氢吗啡酮0.02 mg/kg（H组）,随后静脉注射异丙酚1.5 mg/kg,待睫毛反射消失后开始置入结肠镜,检查过程中出现体动反应时,追加异丙酚首剂量的半量.记录麻醉诱导时间、诊疗操作时间、苏醒时间、恢复时间、术中心血管不良事件、恶心呕吐及呼吸抑制发生情况及异丙酚用量.结果 3组麻醉诱导时间、诊疗操作时间、苏醒时间、恢复时间、心血管不良事件及异丙酚用量比较差异无统计学意义（P＞0.05）.与F组比较,H组和O组恶心呕吐和呼吸抑制的发生率降低,程度减轻（P＜0.05）.O组和H组恶心呕吐和呼吸抑制的发生率和程度比较差异无统计学意义（P＞0.05）.结论 羟考酮或氢吗啡酮复合异丙酚麻醉可安全有效地用于结肠镜诊疗术,其效果优于芬太尼复合异丙酚麻醉.Objective To evaluate the efficacy of oxycodone or hydromorphone combined with propofol for colonoscopy.Methods A total of 150 patients of both sexes,aged 18-64 yr,weighing 45-85 kg,of ASA physical status Ⅰ or Ⅱ,undergoing colonoscopy,were randomly divided into 3 groups （n=50） using a random number table：fentanyl combined with propofol group （group F）,oxycodone combined with propofol group （group O） and hydromorphone combined with propofol （group H）.In F,O and H groups,fentanyl 1 μg/kg,oxycodone 0.1 mg/kg and hydromorphone 0.02 mg/kg were injected over 60 s,respectively,and then propofol 1.5 mg/kg was injected intravenously.After eyelash reflex disappeared,a colonoscope was placed.When body movement occurred during examination,half of the initial dose of propofol was added.The time for induction of anesthesia,operation time,emergence time,recovery time,occurrence of adverse cardiovascular events,nausea and vomiting and respiratory depression,and amount of propofol consumed were recorded.Results There was no significant difference between the three groups in the time for induction of anesthesia,operation time,emergence time,recovery time,adverse cardiovascular events,respiratory depression,and amount of propofol consumed.Compared with group F,the incidence of nausea and vomiting and respiratory depression was significantly decreased,and the degree was reduced in H and O groups.No significant difference was found between group O and group H in the incidence of nausea and vomiting and respiratory depression and the degree.Conclusion Oxycodone or hydromorphone combined with propofol can be safely and effectively used for colonoscopy and the efficacy is better than that of fentanyl combined with propofol.

关 键 词：羟可酮 氢吗啡酮 二异丙酚 结肠镜检查 

分 类 号：R614[医药卫生—麻醉学]