摘要
目的观察纳布啡复合丙泊酚用于小儿无痛结肠镜检查的有效性及安全性。方法选取2020年5月至2020年10月来本院行无痛结肠镜检查3~6岁患儿90例,采用随机、单盲、对照的方法,通过随机数字表法将其分为2组,每组45例,分别为纳布啡组:纳布啡0.3 mg/kg静脉复合丙泊酚3 mg/kg;舒芬太尼组:舒芬太尼0.2μg/kg静脉复合丙泊酚3 mg/kg。根据肠镜检查步骤,观察两组患儿在各个时间点的生命体征变化,记录诱导时间(induction time,IT)、检查时间(total scan time,ST)、苏醒时间(recovery time,RT)、镇痛效果[采用非插管的行为疼痛量表评分(Modified Behavioral Pain Scale score for non-intubated patients,BPS-NI)>5分和丙泊酚追加量评估]和不良反应发生率。结果两组患儿性别、年龄、体质量、ASA分级、操作类型和息肉数量差异无统计学意义;镇痛剂给药后3 min(T_1)两组患儿的生命体征均较给药前即刻(T_0)降低(P<0.05);纳布啡组T_1时的呼吸频率(respiratory rate,RR)和血氧饱和度(SpO_(2))高于舒芬太尼组(P<0.05),其苏醒时间较舒芬太尼组明显缩短(P<0.01);两组患儿镇痛效果差异无统计学意义;纳布啡组患儿未出现不良反应,舒芬太尼组5例呛咳,两组患儿均未发生严重并发症。结论纳布啡复合丙泊酚用于小儿无痛结肠镜检查镇静镇痛效果好,对呼吸影响小,不良反应发生率低且苏醒快。
Objective To observe the effectiveness and safety of nalbuphine combined with propofol in children with painless colonoscopy. Methods A total of 90 children aged 3 to 6 years from the Children’s Hospital of Chongqing Medical University who underwent painless colonoscopy from May to October 2020 were recruited, and then randomly divided into nalbuphine group(N group, n=45, 0.3 mg/kg nalbuphine injected intravenously with combination of 3 mg/kg propofol) and sufentanil group(S group, n=45, 0.2 μg/kg sufentanil injected intravenously with combination of 3 mg/kg propofol). According to the procedure of colonoscopy, the changes in vital signs were observed in the 2 groups of children at various time points. Induction time(IT), examination time(total scan time, ST), recovery time(RT), analgesic effect [using Modified Behavioral Pain Scale score for non-intubated patients(BPS-NI) score >5 points and additional propofol assessment] and incidence of adverse reactions were also recorded. Results There were no statistical differences in gender, age, body weight, status of American Society of Anesthesiologists(ASA) classification, operation type and number of polyps between the 2 groups(P>0.05). The vital signs were significantly lower in the 2 groups in 3 min after the analgesic administration(T1) than immediately before the administration(T0)(P<0.05). The N group had obviously higher respiratory rate(P<0.05) and oxygen saturation at T1(P<0.05), but shorter recovery time when compared with the S group(P<0.01). However, there was no notable difference in the analgesic effect between the 2 groups. No adverse reactions were observed in the N group, and coughing was seen in 5 cases of the S group. No serious complications occurred in the 2 groups. Conclusion Nalbuphine combined with propofol has good sedative and analgesic effects in painless colonoscopy for children, with little impact on breathing, low incidence of adverse reactions and quick recovery.
作者
刘阳
唐文
徐颖
崔洁
张甜歌
彭银俊丞
LIU Yang;TANG Wen;XU Ying;CUI Jie;ZHANG Tiange;PENG Yinjuncheng(Department of Anesthesiology,Children's Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Key Laboratory of Child Development and Disorders of Ministry of Education,Chongqing Key Laboratory of Pediatrics,Chongqing,400014,China)
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2021年第13期1269-1274,共6页
Journal of Third Military Medical University
基金
重庆市技术创新与应用示范(社会民生类)一般项目(cstc2018jscx-msybX0104)。
关键词
纳布啡
结肠镜检查
镇痛
儿童
nalbuphine
colonoscopy
analgesia
children
