丙泊酚联合地佐辛在日间经内镜逆行胰胆管造影术麻醉中的应用  

Application of propofol combined with dezocine in endoscopic retrograde cholangiopancreatography

作　　者：侯明[1] 郭蕾[1] 毕严斌[1] 王月兰[1] 

机构地区：[1]山东省千佛山医院麻醉科,济南市250014

出　　处：《临床麻醉学杂志》2016年第10期963-965,共3页Journal of Clinical Anesthesiology

摘　　要：目的分析丙泊酚联合地佐辛用于日间经内镜逆行胰胆管造影术（ERCP）麻醉的安全性及有效性。方法选择我院行ERCP患者566例,男292例,女274例,年龄40~70岁,体重40~85kg,ASAⅠ或Ⅱ级,随机分为丙泊酚联合芬太尼组（F组）和丙泊酚联合地佐辛组（D组）,每组283例。F组先给予芬太尼100μg,D组给予地佐辛5mg,3min后两组均给予丙泊酚2mg/kg,术中调整丙泊酚用量在3~5mg·kg^-1·h^-1,维持BIS值在50~55。记录患者丙泊酚总用量、麻醉时间、苏醒时间及术后不良反应（呃逆、呛咳、恶心、呕吐）发生情况;统计术后48h内患者出院情况。结果D组苏醒时间（5.1±1.1）min明显短于F组（5.6±2.5）min（P〈0.05）;D组术后恶心、呕吐发生率（4%和0%）明显低于F组（9%和1%）（P〈0.05）;术后48h内D组出院率（30%）明显高于F组（18%）（P〈0.05）。结论丙泊酚2mg/kg联合地佐辛5mg/kg应用于ERCP手术血流动力学更稳定,恶心、呕吐发生率低,住院时间短。Objective To investigate safety and feasibility of propofol combined with dezocine in ambulatory ERCP.Methods Five hundred and sixty-six patients were collected in our hospital in recent two years suffering ERCP were randomly divided into two groups,292 males,274 females,aged from 40 to 70years,weight from 40 to 85kg：group F was given fentanyl 100μg,group D was given dezocine 5mg;then propofol was given at 2mg/kg in both two groups in 3min,continuely at3-5mg·kg^-1·h^-1 under BIS value at 50-55.MAP,HR,SpO2 were observed and compared at five points：before anesthesia induction（T0）,immediately after induction（T1）,through the throat instantly（T2）,immediately before the end of operation（T3）,awakening time（T4）,comparing the total volume of propofol,recovery time,postoperative complication;the discharge number within 48 hours of the operation was analyzed.Results Shorter recovery time[（15.1±1.1）min vs.（5.6±2.5）min]and less adverse reactions（4% vs.9%,0% vs.1%）occurred in group D than group F（18%）（P〈0.05）;more patients were discharged within 48 hours in group D（30%）than group F（P〈0.05）.Conclusion Propofol 2 mg/kg combined with dezocine is more suitable for ambulatory surgery about ERCP for its stable circulatory system value,less adverse reactions and shorter hospitalization time.

关 键 词：经内镜逆行胰胆管造影术 丙泊酚 地佐辛 日间手术 

分 类 号：R614.2[医药卫生—麻醉学]