盐酸氢吗啡酮复合丙泊酚在无痛结肠镜检查中的应用

目的 观察盐酸氢吗啡酮复合丙泊酚麻醉用于无痛结肠镜的镇痛效果及安全性.方法 选择60例结肠镜检查患者,ASA分级Ⅰ、Ⅱ级,采用随机数字表法分为盐酸氢吗啡酮复合丙泊酚组(A组)和单纯丙泊酚组(B组),每组30例.A组给予盐酸氢吗啡酮0.5 mg(生理盐水稀释至5 ml缓慢静脉注射)复合丙泊酚麻醉,B组给予等量生理盐水复合丙泊酚麻醉.记录两组患者麻醉前(T0)、检查即刻(T1)、结肠镜到达回盲部时(T2)及术毕(T3)的SBP、HR及SpO2,并观察两组丙泊酚用量、副作用、术后疼痛VAS评分、苏醒时间、检查操作时间以及离院时间.结果 与T0比较,在T1、T2时点两组HR明显减慢,SBP和SpO2明显降低(P＜0.05),其中B组在T1、T2时间点的SBP和HR下降比A组明显(P＜0.05);丙泊酚用量A组[(103±14) mg]明显少于B组[(170±22) mg] (P＜0.05),术后VAS评分A组[(1.2±0.6)分]低于B组[(3.0±0.6)分](P＜0.05),体动反应A组(5例)明显少于B组(18例)(P＜0.05).结论 盐酸氢吗啡酮复合丙泊酚可安全用于无痛结肠镜检查并减少丙泊酚用量,麻醉平稳、效果确切.

The application of hydromorphone combined with propofol in colonoscopy

Objective To investigate the effect and safety of hydromorphone combined with propofol for patients underwent colonoscopy.Methods Sixty outpatients were randomly divided into group A and group B with 30 patients in each group, of ASA physical status Ⅰ or Ⅱ, according to random number tables.Anesthesia was induced with hydromorphone 0.5 mg and propofol for patients in group A , while patients in group B were induced with normal saline and propofol.The SBP, HR and SpO2 were recorded before examination(T0), inserting colonoscopy simuhaneously(T1), reaching ileocecum junction(T2), and at the end of examination(T3).Propofol consumption, side effects, post-operative VAS scores, recovery time, examination time and discharge time were recorded accordingly.Results The anesthesia effect in group A was better than that in group B (P＜0.05).The HR, SBP and SpO2 in two groups at T1 and T2 were lower than those at T0 (P＜0.05).Both of the SBP and HR in group B at T1 and T2 were significantly lower than those in group A (P＜0.05).The propofol consumption [(103±14) mg] in group A was significantly less than that in group B [(170±22) mg] (P＜0.05).The VAS scores (1.2±0.6) in group A was lower than that in group B (3.0±0.6)(P＜0.05).The movement response occurred in 5 and 18 patients in group A and B (P＜0.05), respectively.Conclusions Hydromorphone combined with propofol can be safely used for patients underwent painless colonoscopy and reduce propofol consumption.