洛贝林在老年患者消化内镜治疗静脉麻醉中的应用价值  

Application value of lobeline in elderly patients undergoing intravenous anesthesia under digestive endoscopy

作　　者：胡泽凡 胡忠诚 马建 岳定雄 张凯 李琳 Hu Zefan;Hu Zhongcheng;Ma Jian;Yue Dingxiong;Zhang Kai;Li Lin(Department of Anesthesiology,First People's Hospital of Xiaogan City,Xiaogan 432100,China)

机构地区：[1]孝感市第一人民医院麻醉科,湖北孝感432100

出　　处：《中华消化病与影像杂志（电子版）》2021年第6期271-275,共5页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：孝感市自然科学计划项目(XKGJ2020010082)。

摘　　要：目的探讨洛贝林在老年患者消化内镜治疗静脉麻醉中的应用价值。方法回顾性分析2018年4月至2020年8月孝感市第一人民医院收治的需在静脉麻醉下行消化内镜治疗的200例老年患者,按照随机数字表法随机分为观察组和对照组,每组各100例。观察组患者静脉麻醉用药为洛贝林3 mg+地佐辛0.05 mg/kg+丙泊酚1~2 mg/kg,对照组患者静脉麻醉用药为地佐辛0.05 mg/kg+丙泊酚1~2 mg/kg,待睫毛反射消失,脑电双频指数(BIS)为50~60后进行治疗,术中根据治疗进度间断追加丙泊酚0.5 mg/kg,维持BIS 50~60。常规监测患者平均动脉压(MAP)、心电图(ECG)、脉搏血氧饱和度(SPO_(2))、BIS、旁流式呼气末二氧化碳分压(PETCO_(2))。记录两组患者麻醉给药后1 min (T_(1))、3min (T_(2))、5 min (T_(3))、10 min (T_(4))、15 min (T_(5)) PETCO_(2)、Sp O_(2)、术后清醒时间、出恢复室时间、呼吸暂停、低氧血症、苏醒延迟发生率,并进行比较。结果观察组患者麻醉给药后不同时间点PETCO_(2)、Sp O_(2)均高于对照组患者,呼吸暂停、低氧血症发生率则低于对照组患者,且差异均有统计学意义(P均<0.05);两组患者MAP、心率、术后清醒时间、出恢复室时间、苏醒延迟发生率差异均无统计学意义(P均>0.05)。结论洛贝林应用于老年患者消化内镜治疗短时静脉麻醉中,能有效增加患者呼吸幅度和呼吸频率,维持稳定的Sp O_(2),降低患者低氧血症发生率,而且不延长患者术后苏醒和出恢复室时间,安全性高。Objective To investigate the application value of lobeline in digestive endoscopy intravenous anesthesia elderly patients.Methods A total of 200 elderly patients who were treated with digestive endoscopy under intravenous anesthesia in First People’s Hospital of Xiaogan City from April 2018 to August 2020 were retrospectively analyzed.According to the random number table method,they were randomly divided into observation group and control group,with 100 cases in each group.The observation group was anesthetized with lobeline 3 mg+dezocine 0.05 mg/kg+propofol 1-2 mg/kg,and the control group was anesthetized with dezocine 0.05 mg/kg+propofol 1-2 mg/kg.After the eyelash reflex disappeared,and the bispectral index (BIS) value was 50-60,the treatment was carried out.Propofol 0.5 mg/kg was added intermittently during the operation according to the progress of treatment,and BIS value was maintained at 50-60.The mean arterial pressure (MAP),electrocardiogram (ECG),pulse oxygen saturation (SpO_(2)),BIS value and side flow end expiratory carbon dioxide partial pressure (PETCO2) were routinely monitored.PETCO2value,Sp O2value,awake time,time out of recovery room,incidences of apnea,hypoxemia and delayed recovery were measured at 1 min (T_(1)),3 min (T_(2)),5 min (T_(3)),10 min (T_(4)) and 15 min (T_(5)) after anesthesia administration and compared between the two groups.Results PETCO_(2) and Sp O_(2)values of the observation group were higher than those of the control group at different time points after anesthesia administration,while the incidences of apnea and hypoxemia were lower than that of the control group,and there were statistically significant differences (P<0.05).There were no statistically significant differences in MAP,heart rate,postoperative recovery time,time out of recovery room and incidence of delayed recovery between the two groups (P>0.05).Conclusion Lobeline can effectively increase the respiratory amplitude and respiratory rate,maintain stable SpO_(2),reduce the incidence of hypoxemia,and does not

关 键 词：洛贝林 老年患者 消化内镜 静脉麻醉 

分 类 号：R614[医药卫生—麻醉学]