纳布啡复合丙泊酚对接受无痛胃镜联合结肠镜检查术老年患者麻醉效果及神经认知功能的影响  

Influences of nalbuphine combined with propofol on anesthetic effect and neurocognitive function in elderly patients undergoing painless gastroscopy combined with colonoscopy

作　　者：路凯[1] 陈方[1] 白宁[1] 程方圆 谢永业 LU Kai;CHEN Fang;BAI Ning;CHEN Fangyuan;XIE Yongye(Anesthesiology Department,Shaanxi Provincial People's Hospital,Xi'an 710068,China)

机构地区：[1]陕西省人民医院麻醉科,陕西西安710068

出　　处：《临床医学研究与实践》2021年第24期39-41,共3页Clinical Research and Practice

基　　金：陕西省自然科学基础研究计划项目(No.2019JQ-975)。

摘　　要：目的探讨纳布啡复合丙泊酚对接受无痛胃镜联合结肠镜检查术老年患者麻醉效果及神经认知功能的影响。方法选择于我院胃肠镜室行无痛胃镜联合结肠镜检查术的154例老年患者为研究对象,采用随机数字表法将其分为对照组和研究组,各77例。对照组患者接受舒芬太尼复合丙泊酚麻醉,研究组患者接受纳布啡复合丙泊酚麻醉。比较两组患者的麻醉效果。结果麻醉清醒后5、30 min,研究组的Ramsay及VAS评分均显著低于对照组(P<0.05)。研究组的苏醒时间、定向力恢复时间、术毕至离开时间显著短于对照组,睫毛反射次数、丙泊酚用量显著少于对照组(P<0.05)。研究组的各项不良反应发生率显著低于对照组(P<0.05)。术后2~4 h、术后7 d,研究组的MoCA、DST、DSST评分均显著高于对照组(P<0.05)。结论纳布啡复合丙泊酚的镇痛、镇静效果显著,可减少丙泊酚用量,有效保护神经认知功能,缩短麻醉苏醒时间,尤其适用于接受无痛胃镜联合结肠镜检查术的老年患者。Objective To investigate the Influences of nalbuphine combined with propofol on anesthetic effect and neurocognitive function in elderly patients undergoing painless gastroscopy combined with colonoscopy.Methods A total of 154 elderly patients who underwent painless gastroscopy combined with colonoscopy in the gastroenteroscopy room of our hospital were selected as the study objects.The patients were divided into control group and study group by random number table method,with 77 cases in each group.The control group received sufentanil combined with propofol anesthesia,and the study group received nalbuphine combined with propofol anesthesia.The anesthetic effects of the two groups were compared.Results The Ramsay and VAS scores of the study group were significantly lower than those of the control group at 5 and 30 min after anesthesia awareness(P<0.05).The recovery time,orientation recovery time and post-surgery to leaving time of the study group were significantly shorter than those of the control group,and the times of eyelash reflex and propofol dosage were significantly lower than those of the control group(P<0.05).The incidences of adverse reactions in the study group were significantly lower than those in the control group(P<0.05).The scores of MoCA,DST and DSST in the study group were significantly higher than those in the control group at 2 to 4 h and 7 d after operation(P<0.05).Conclusion Naborphine combined with propofol has a significant analgesic and sedative effect,which can reduce the propofol dosage,effectively protect neurocognitive function,and shorten the recovery time of anesthesia.It is especially suitable for elderly patients undergoing painless gastroscopy combined with colonoscopy.

关 键 词：无痛胃镜联合结肠镜检查术 纳布啡 丙泊酚 麻醉效果 神经认知功能 

分 类 号：R614[医药卫生—麻醉学]