丙泊酚复合布托啡诺用于无痛胃镜麻醉的临床观察-第三军医大学学报.doc

丙泊酚复合布托啡诺用于无痛胃镜麻醉的临床观察 韩丽春1 曾文斌1 秦玲1白晓鋆1 党晓东1 柴伟2* （1陕西省第三人民医院麻醉科， 西安710061；2第四军医大学附属唐都医院麻醉科，西安 710038） 作者简介：韩丽春（1977），女，陕西省西安市人， 博士，主治医师，电话；E-mail hanlichun696@163.com 通讯作者：柴伟. 第四军医大学唐都医院麻醉科 电话：(029)[摘 要] 目的 观察布托啡诺复合丙泊酚用于门诊无痛胃镜的麻醉效果。方法 门诊ASA 1~2级无痛胃镜检查的患者61例，随机分为3组，即单纯丙泊酚组（P）15例、丙泊酚复合芬太尼组（PF）23例和丙泊酚复合布托啡诺组（PB）23例，观察入室后 (t1)、置镜前 (t2)、置镜中 (t3)、出镜后 (t4) 各时点MAP、HR、RR、 SPO2及意识恢复时间、定向力恢复时间、Ramsay镇静评分、丙泊酚用量及不良反应。结果 P组麻醉效果有效率为86.7%，PF、PB组有效率100％。各组t1时点的MAP、HR、RR、SPO2与t2,t3及t4各时点相比均有显著变化（P0.05），其中P组有4例出现低血压，3例出现低血氧症，PF组有3例出现低血氧，PB组无一例出现低血压及低血氧。意识恢复时间及定向力恢复时间 P组与PF、PB三组之间相比均有显著性差异（P0.05），Ramsay评分无显著性差异，丙泊酚用量P组与PF、PS组相比显著增加（P0.05）。结论 丙泊酚复合布托啡诺不仅可以减少丙泊酚用量，有效降低呼吸抑制副反应，而且缩短苏醒时间，使整个检查过程更加平稳，周转加快。 [关键词] 布托啡诺 无痛胃镜 丙泊酚 麻醉 The clinical observation of Propofol combined with butophanol used for painless gastroscopes Han Li-chun,1 Zeng Wen-bin,1 Qin Ling,1 Bai Xiao-jun,1 Dang Xiao-dong,1 Chai Wei2* (1Department of Anesthesiology, Shaanxi Tumor Hospital; 2 Department of Anesthesiology, TangDu Hospital, the Fouth Military Medical University) [Abstract] Purpose observe the clinical effects of Propofol combined with butophanol used for painless gastroscopes. Methods 61 patients in out-patient from the ASA groups I and II, planned for painless gastroscopes, were included in the study. Subjects were randomly divided into three groups and propofol only administrated intravenously for group P, infusion propofol and fentanyl for group PF and infusion propofol and butophanol for group PB. All the subjects were monitored and recorded MAP, HR, RR and SPO2 before drug administrated (t1), after drug administrated but before gastroscopes putting (t2), during gastroscopes putting (t3) and after gastroscopes taking out (t4). The dose of propofol, waking time, orientation recovery time, Ramay scale, and adverse effect are recorded. Results MAP, HR, RR and SPO2 were decreased significantly on t2,t3 and t4 compared with t1. MAP, RR and SPO2 in PB group had significant difference