摘要
目的研究丙泊酚复合布托啡诺静脉麻醉的效果、安全性以及在门诊手术推广应用的可行性。方法 120例拟行门诊手术的患者,随机分成A组、B组、C组,每组40例。A组患者采用单纯丙泊酚静脉注射麻醉,B组患者采用芬太尼联合丙泊酚静脉注射麻醉,C组患者采用布托啡诺联合丙泊酚静脉注射麻醉,记录麻醉前、注药后2 min、苏醒时平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_2)及麻醉起效时间、手术持续时间、唤醒时间、丙泊酚用量、麻醉效果分级、麻醉相关不良反应和镇静评分标准(Ramsay)评分。结果 B、C组给药结束至睫毛反射消失时间明显长于A组(P<0.01),B、C组的唤醒时间均显著短于A组(P<0.05),A组丙泊酚总用量多于B、C组(P<0.01)。注药后2 min,三组患者的SpO_2显著低于麻醉前,HR慢于麻醉前(P<0.01);B、C组的SpO_2明显低于A组(P<0.05)。A组优良率为80.0%、B组优良率为97.5%、C组优良率为97.5%,B、C组麻醉效果明显优于A组,差异具有统计学意义(P<0.05),三组患者两两组间Ramsay评分对比差异无统计学意义(P>0.05)。B组患者SpO_2<90%发生率高于C组(P<0.05),B组患者恶心发生率高于A、C组(P<0.05),B组术后呕吐发生率明显高于A组(P<0.05),C组苏醒期头晕发生率明显低于A、B组(P<0.05),C组苏醒期兴奋躁动发生率明显低于A组(P<0.05)。结论丙泊酚复合布托啡诺静脉麻醉镇痛满意,不仅可减少丙泊酚用量,有效降低呼吸抑制等不良反应,而且缩短苏醒时间,适宜在门诊短时手术中推广应用。
Objective To research effect, safety, and feasibility by propofol combined with butorphanol in intravenous anesthesia for outpatient short-time operation. Methods A total of 120 patients in outpatient operation were randomly divided into group A, group B and group C, with 40 cases in each group. Group A received single propofol in intravenous anesthesia, group B received fentanyl combined with propofol in intravenous anesthesia, and group C received propofol combined with butorphanol in intravenous anesthesia. Records were made on mean arterial pressure（MAP）, heart rate（HR）, oxyhemoglobin saturation（SpO2）, anesthesia onset time, operation duration, wake-up time, propofol dosage, anesthetic effect grade before anesthesia, after 2 min of drug injection and after recovery, and anesthesia related adverse reactions and Ramsay score. Results Groups B and C showed obviously longer time between drug administration end and eyelash reflex disappearance than group A（P〈0.01）, and groups B and C had much shorter wake-up time than group A（P〈0.05）, while group A had higher total propofol administration dose than groups B and C（P〈0.01）. After drug injection for 2 min, all three groups had much lower SpO2 and slower HR than those before anesthesia（P〈0.01）, and groups B and C had much lower SpO2 than group A（P〈0.05）. Group A had good rate as 80.0%, group B had good rate as 97.5%, and group C had good rate as 97.5%. Groups B and C had obviously better anesthetic effect than group A, and their difference had statistical significance（P〈0.05）. There was no statistically significant difference of Ramsay scores between each two groups（P〉0.05）. Group B had higher incidence of SpO2 〈90% than group C（P〈0.05）. Group B had higher incidence of nausea than groups A and C（P〈0.05）, and group B had obviously higher incidence of postoperative emesis than group A（P〈0.05）. Group C had much lower incidence of dizziness in recovery period than groups A and B（P〈0.05）, and g
出处
《中国实用医药》
2017年第8期4-6,共3页
China Practical Medicine
关键词
丙泊酚
布托啡诺
静脉麻醉
门诊短时手术
Propofol
Butorphanol
Intravenous anesthesia
Outpatient short-time operation
