酒石酸布托啡诺联合丙泊酚用于无痛胃镜下ESD患者的有效性与安全性观察  

Observation of efficacy and safety of butorphanol tartrate combined with propofol in patients with ESD under painless gastroscopy

作　　者：米延起[1] 赵萍[2] 王凯[1] 梅丽莎 MI Yan-qi;ZHAO Ping;WANG Kai(Department of Pharmacy,Weifang People's Hospital,Weifang 261041,China)

机构地区：[1]潍坊市人民医院药剂科,261041 [2]潍坊市人民医院麻醉科,261041

出　　处：《中国实用医药》2024年第16期97-100,共4页China Practical Medicine

基　　金：山东省潍坊市卫生健康委项目(项目编号:WFWSJK-2021-227)。

摘　　要：目的研究酒石酸布托啡诺联合丙泊酚对无痛胃镜下内镜黏膜下剥离术(ESD)患者的有效性和安全性。方法90例拟行无痛胃镜下ESD治疗患者,采用随机数字表法分为B1组、B2组及S组,每组30例。B1组、B2组分别于丙泊酚麻醉诱导前5 min给予10、20μg/kg酒石酸布托啡诺,S组于丙泊酚麻醉诱导前5 min给予等量生理盐水。比较三组的麻醉苏醒时间、丙泊酚用量、体动发生率,麻醉诱导前(T1)、置镜前(T2)、置镜中(T3)、出镜后(T4)的平均动脉压(MAP)、心率(HR)、脉搏氧饱和度(SpO_(2)),低氧血症发生率及不良反应发生率。结果B1组麻醉苏醒时间(6.00±0.56)min短于B2组的(6.77±0.37)min、S组的(6.25±0.33)min,B2组麻醉苏醒时间长于S组(P<0.05);B1组、B2组丙泊酚用量分别为(240.65±13.36)、(200.36±14.58)mg,均少于S组的(270.44±17.38)mg,B1组丙泊酚用量多于B2组(P<0.05);实验过程中S组有10例出现体动,B1组出现3例体动、B2组出现2例体动,B1组、B2组体动发生率分别为10.0%、6.7%,低于S组的33.3%(P<0.05)。T1时,三组患者的HR、MAP、SpO_(2)比较,差异无统计学意义(P>0.05)。与T1时比较,三组患者T2、T3、T4时的MAP均下降(P<0.05);但B1组、B2组患者T2时的MAP均高于S组(P<0.05)。与T1时比较,S组患者T2、T3、T4时的HR均下降,B1组、B2组患者T2、T3时的HR均下降(P<0.05);但B1组、B2组患者T2时的HR高于S组(P<0.05)。与T1时比较,三组患者T2、T3时的SpO_(2)均下降(P<0.05);但B1组、B2组患者T2、T3时的SpO_(2)高于S组(P<0.05)。S组低氧血症发生率26.7%(8/30)明显高于B1组的6.7%(2/30)、B2组的3.3%(1/30)(P<0.05);B2组头晕发生率26.7%(8/30)明显高于S组的0、B1组的6.7%(2/30)(P<0.05)。结论10μg/kg酒石酸布托啡诺复合丙泊酚可以安全、有效地应用于无痛胃镜下ESD患者中,有效提升麻醉效果的同时,可减少不良反应的发生。Objective To study the efficacy and safety of butorphanol tartrate combined with propofol in patients with endoscopic submucosal dissection(ESD)under painless gastroscopy.Methods 90 patients who planned to receive ESD under painless gastroscopy were divided into group B1,group B2,group S by random number table method,each with 30 cases.Group B1 and group B2 were given 10μg/kg and 20μg/kg butorphenol tartrate 5 min before induction of propofol anesthesia,respectively.Group S was given the same amount of normal saline 5 min before anesthesia induction with propofol.Comparison was made on anesthesia recovery time,dosage of propofol,incidence of body movement,mean arterial pressure(MAP),heart rate(HR),pulse oxygen saturation(SpO_(2))before anesthesia induction(T1),before placement of the scope(T2),during placement of the scope(T3),and after placement of the scope(T4),incidence of hypoxemia,and incidence of adverse reactions among the three groups.Results The anesthesia recovery time was(6.00±0.56)min in group B1,which was shorter than(6.77±0.37)min in group B2 and(6.25±0.33)min in group S;the anesthesia recovery time in group B2 was longer than that in group S(P<0.05).The dosage of propofol was(240.65±13.36)and(200.36±14.58)mg in group B1 and group B2,which was less than(270.44±17.38)mg in group S;the dosage of propofol in group B1 was more than that in group B2(P<0.05).During the experiment,there were 10 cases of body movement in group S,3 cases in group B1 and 2 cases in group B2.The incidence rates of body movement in group B1 and group B2 were 10.0%and 6.7%,which was lower than 33.3%in group S(P<0.05).At T1,there was no significant difference in HR,MAP and SpO_(2)among the three groups(P>0.05).Compared with T1,MAP at T2,T3 and T4 in all three groups decreased(P<0.05).However,MAP of patients in group B1 and B2 at T2 was higher than that in group S(P<0.05).Compared with that at T1,HR at T2,T3 and T4 decreased in patients of group S;HR at T2 and T3 decreased in patients of group B1 and group B2(P<0.05).Howev

关 键 词：酒石酸布托啡诺 丙泊酚 胃肠镜 内镜黏膜下剥离术 麻醉效果 

分 类 号：R614[医药卫生—麻醉学]