羟考酮联合丙泊酚与舒芬太尼联合丙泊酚在气道困难者中的应用  

Application of Oxycodone Combined With Propofol and Sufentanil Combined With Propofol in Patients With Difficult Airway

作　　者：张武华[1] 张宇菲 ZHANG Wuhua;ZHANG Yufei(Department of Anesthesiology,Xiamen Hospital of Traditional Chinese Medicine,Xiamen Fujian 361000,China;Department of Anesthesiology,Shengjing Hospital Affiliated to China Medical University,Shenyang Liaoning 110000,China)

机构地区：[1]厦门市中医院麻醉科,福建厦门361000 [2]中国医科大学附属盛京医院麻醉科,辽宁沈阳110000

出　　处：《中国卫生标准管理》2022年第11期156-159,共4页China Health Standard Management

摘　　要：目的羟考酮联合丙泊酚与舒芬太尼联合丙泊酚对气道困难者的应用研究。方法选取厦门市中医院2019年5月—2021年5月收治的240例接受无痛胃镜检查的气道困难患者为本次研究对象,将所有患者按照随机数表法分成对照组(n=120)与观察组(n=120)。对照组采用0.05μg/kg舒芬太尼复合2.0 mg/kg丙泊酚静脉注射麻醉处理,观察组采用0.05 mg/kg羟考酮复合2.0 mg/kg丙泊酚进行静脉注射麻醉处理。观察记录两组患者麻醉前(t_(0))、麻醉后(t_(1))、入镜之际(t_(2))、入镜3 min(t_(3))、退镜之际(t_(4))等不同时间节点的心率(heart rate,HR)、血氧饱和度(blood oxygen saturation,SpO_(2))、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)等各项生命体征的变化;对比两组接受麻醉处理后出现低血压、心动过缓、呼吸抑制、恶心呕吐等不良反应的概率。结果两组患者t_(1)、t_(2)、t_(3)等时间节点的HR数值、SBP数值、DBP数值等均较t_(0)时间点出现了较为明显的下降迹象(P<0.05),而在t_(4)时间点,两组HR、SBP、DBP与t_(0)时间点对比差异无统计学意义(P>0.05);对照组t_(1)时间点、t_(2)时间点、t_(3)时间点及t_(4)时间点分别与t_(0)时SpO_(2)水平数值对比有显著下降(P<0.05);t_(1)时间点、t_(2)时间点、t_(3)时间点及t_(4)时间点分别与t_(0)时SpO_(2)水平数值对比有显著升高(P<0.05),但两组t_(3)、t_(4)时间点的SpO_(2)水平与t_(0)时间点的SpO_(2)水平数值对比差异无统计学意义(P>0.05);观察组出现低血压、心动过缓、呼吸抑制、恶心呕吐等不良反应的概率均低于对照组,差异有统计学意义(P<0.05)。结论羟考酮联合丙泊酚的麻醉处理效果更优于舒芬太尼联合丙泊酚,可降低患者出现低血压、呼吸抑制等多种不良反应的风险系数,更能维持患者血流动力学的平稳性,具有更高的应用安全性,值得在无痛胃镜检查中进行应用与推广。Objective To study the application of oxycodone combined with propofol and sufentanil combined with propofol in patients with airway difficulties.Methods A total of 240 patients with airway difficulties undergoing painless gastroscopy in Xiamen Hospital of Traditional Chinese Medicine from May 2019 to May 2021 were selected as the subjects of this study.All patients were randomly divided into the control group(n=120)and the observation group(n=120).The control group was treated with 0.05μg/kg sufentanil combined with 2.0 mg/kg propofol for intravenous anesthesia,and 0.05 mg/kg oxycodone combined with 2.0 mg/kg propofol for intravenous anesthesia in the observation group.The changes of heart rate(HR),blood oxygen saturation(SpO_(2)),systolic arterial pressure(SBP),diastolic arterial pressure(DBP)and other vital signs at different time points before anesthesia(t_(0)),after anesthesia(t_(1)),at the time of entering the mirror(t_(2)),at the time of entering the mirror(t_(3)),at the time of withdrawing the mirror(t_(4))were observed and recorded.The probability of adverse reactions such as hypotension,bradycardia,respiratory depression,nausea and vomiting were compared between the two groups.Results Compared with the time point of t_(0),the HR value,SBP value,DBP value of the two groups of patients at t_(1),t_(2),t_(3) time points showed obvious signs of decline(P<0.05).There was no significant difference in HR,SBP,DBP at t 4 time point in the two groups compared with t_(0) time point(P>0.05);the control group’s SpO_(2) level at t_(1) time point,t_(2) time point,t_(3) time point and t_(4) time point,compared with t0 time point respectively,there was a significant decrease in the comparison(P<0.05);the SpO_(2) levels at t_(1),t_(2),t_(3) and t_(4) were significantly higher than those at t_(0)(P<0.05),but there was no significant difference between the SpO_(2) levels at t_(3) and t_(4) and the SpO_(2) level at t_(0) between the two groups(P>0.05).The probability of adverse reactions such as hypotension,bradycardia,re

关 键 词：不同麻醉方式 气道困难 呼吸抑制 无痛胃镜 麻醉效果 研究情况 

分 类 号：R614[医药卫生—麻醉学]