【摘要】 目的 探究总结Narcotrend(NT)麻醉深度检测仪监测下不同剂量地佐辛复合丙泊酚麻醉在结肠镜检查中的效果。方法 120例结肠镜检查患者,按随机数字表法分为低剂量组与高剂量组,各60例。低剂量组采用0.10 mg/kg地佐辛复合丙泊酚麻醉,高剂量组采用0.15 mg/kg地佐辛复合丙泊酚麻醉。再根据NT值随丙泊酚输入剂量的变化将低剂量组与高剂量组分别分为A1组(NT值：35～45)、B1组(NT值：46～56)、C1组(NT值：57～67)与A2组(NT值：35～45)、B2组(NT值：46～56)、C2组(NT值：57～67),每组20例。比较低剂量组与高剂量组不同时间[给药前(t1)、地佐辛给药10 min后(t2)、效应室浓度的时间(t3)]的收缩压(SBP)、心率(HR)、血氧饱和度(SpO2)及低剂量组和高剂量组丙泊酚用量、苏醒时间、结肠镜检查时间、不良事件发生情况。结果 t2、t3时,两组SBP、HR、SpO2均低于t1时,且高剂量组t2、t3时的SBP、HR、SpO2分别为(107.42±8.64)mm Hg(1 mm Hg=0.133 kPa)、(62.16±10.21)次/min、(97.21±0.81)%与(103.48±9.89)mm Hg、(61.11±7.43)次/min、(96.11±1.31)%,低于低剂量组的(112.63±8.55)mm Hg、(68.87±13.11)次/min、(98.11±0.91)%与(109.43±9.67)mm Hg、(66.98±13.32)次/min、(97.32±1.11)%,差异有统计学意义(P<0.05)。A1组、B1组、C1组的结肠镜检查时间及反流误吸、呛咳体动反应、苏醒期躁动发生率比较,差异无统计学意义(P>0.05)。A1组、B1组、C1组苏醒时间依次缩短,丙泊酚用量依次增加,三组比较差异有统计学意义(P<0.05)。A2组、B2组、C2组的结肠镜检查时间及反流误吸、呛咳体动反应、苏醒期躁动发生率比较,差异无统计学意义(P>0.05)。A2组、B2组、C2组苏醒时间依次缩短,丙泊酚用量依次增加,三组比较差异有统计学意义(P<0.05)。结论 在Narcotrend监测下,围术期使用地佐辛能减少降结肠镜检查手术中丙泊酚的使用量及不良反应,这可为临床麻醉工作中麻醉药物使用提供参考,有利于提高麻醉质量和安全系数,保证患者的生命安全。更多还原

【Abstract】 Objective To investigate the effect of different doses of dezocine combined with propofol anesthesia in colonoscopy under Narcotrend monitoring. Methods A total of 120 patients undergoing colonoscopy were divided into a low-dose group and a high-dose group according to the random numerical table, with 60 patients in each group. The low-dose group was anesthetized with 0.10 mg/kg dezocine and propofol, while the high-dose group was anesthetized with 0.15 mg/kg dezocine and propofol. were further divided into group A1(NT value: 35-45), group B1(NT value: 46-56), group C1(NT value: 57-67) and group A2(NT value: 35-45),group B2(NT value: 46-56), group C2(NT value: 57-67) according to the change of NT value with the input dose of propofol, with 20 patients in each group. Comparison was made on systolic blood pressure(SBP), heart rate(HR),oxygen saturation(SpO2) at different time points [before administration(t1), after 10 min of dezocine administration(t2), and time to effector compartment concentration(t3)], propofol dosage, recovery time, time to colonoscopy and occurrence of adverse events between the low-dose group and the high-dose group. Results At t2 and t3,the SBP, HR, and SpO2 in both groups were lower than those at t1; the SBP, HR, SpO2 in the high-dose group were(107.42±8.64) mm Hg(1 mm Hg=0.133 kPa),(62.16±10.21) beats/min,(97.21±0.81)% and(103.48±9.89) mm Hg,(61.11±7.43) beats/min,(96.11±1.31)%, which were lower than(112.63±8.55) mm Hg,(68.87±13.11) beats/min,(98.11±0.91)% and(109.43±9.67) mm Hg,(66.98±13.32) beats/min,(97.32±1.11)% in the low-dose group; the differences were statistically significant(P<0.05). The differences were not statistically significant(P>0.05) when comparing the time to colonoscopy, incidence of reflux and aspiration,choking somatic movement reaction, and emergence agitation in group A1, group B1, and group C1. The recovery time of group A1, group B1, and group C1 was shortened successively, while the dosage of propofol was increased successively, and the difference was statistically significant(P<0.05). The differences were not statistically significant(P>0.05) when comparing the time to colonoscopy, incidence of reflux and aspiration, choking somatic movement reaction, and emergence agitation in group A2, group B2, and group C2. The recovery time of group A2, group B2, and group C2 was shortened successively, while the dosage of propofol was increased successively,and the difference in the three groups was statistically significant(P<0.05). Conclusion Under Narcotrend monitoring, the perioperative use of dezocine can reduce the doses of propofol during colonoscopy and reduce adverse reactions, which could provide references for the use of narcotic drugs in clinical anesthesia, and be conducive to the improvement of anesthesia quality and safety factor, so as to ensure the life safety of patients.更多还原