不同浓度纳布啡在小儿胃镜中的应用效果及对检查不良事件的影响

目的探讨不同浓度纳布啡在小儿胃镜中的应用效果及对检查不良事件的影响。方法选择2018年2月至2019年12月于上海交通大学医学院附属上海儿童医学中心进行无痛胃镜检查的255例患儿,采用随机数字表法,根据纳布啡给药浓度分为A组(0.10 mg/kg)、B组(0.15 mg/kg)、C组(0.20 mg/kg),每组85例。分别于麻醉前(T0)、置入胃镜时(T1)以及胃镜退出时(T2)比较3组患儿的心率(HR)、平均动脉压(MAP)以及血氧饱和度(SpO₂)。比较各组患儿的麻醉效果,同时记录丙泊酚使用总量、胃镜检查时间,比较患儿苏醒和离院时间,术中和术后不良事件发生情况。结果 3组患儿HR、MAP、SpO₂在各时间(T0、T1、T2)点组间、组内比较差异无统计学意义(P>0.05)。与B组、C组比较,A组丙泊酚总用量多、停药后苏醒时间长(P<0.05),B组、C组比较差异无统计学意义(P>0.05)。C组离院时间长于A组、B组(P<0.05),A组、B组比较差异无统计学意义(P>0.05)。B组、C组麻醉优良率高于A组(P<0.05),B组、C组比较差异无统计学意义(P>0.05)。C组术中呼吸抑制,术后恶心呕吐、眩晕发生率高于A组、B组(P<0.05),A组、B组比较差异无统计学意义(P>0.05)。结论不同浓度纳布啡对小儿胃镜检查者丙泊酚使用量存在影响,0.15 mg/kg纳布啡配伍合适剂量丙泊酚具有良好的麻醉效果和安全性。

Different concentrations of nalbuphine in pediatric gastroscopy and the influences on adverse events

Objective To explore the application effect of different concentration of nalbuphine in children′s gastroscopy and its impacts on adverse events.Methods A total of 255 children undergoing painless gastroscopy in Shanghai Children′s Medical Center from February 2018 to December 2019 were randomly divided into group A(0.10 mg/kg),group B(0.15 mg/kg)and group C(0.20 mg/kg)according to the concentrations of nalbuphine(n=85,each).Before anesthesia(T0),at gastroscope insertion(T1)and at gastroscope withdrawal(T2),heart rate(HR),mean arterial pressure(MAP)and pulse oxygen saturation(SpO₂)were measured and compared among three groups.The anesthesia effect,the total amount of propofol used,the time of gastroscopy,the consciousness time,the discharge time and the occurrence of intraoperative and postoperative adverse events were recorded and compared among three groups.Results There were no significant differences in HR,MAP and SpO₂ at T0,T1 and T2 among the three groups(P>0.05).The total dosage of propofol and the recovery time in group A were statistically higher than those in group B and group C(P<0.05),but there were no significant differences between group B and group C(P>0.05).The discharge time in group C was significantly longer than that in group A and group B(P<0.05),and there was no significant difference between group B and group C(P>0.05).The incidence of respiratory depression,nausea,vomiting and vertigo in group C was significantly higher than those in group A and group B(P<0.05),and there was no significant difference in it between group A and group B(P>0.05).Conclusion The different concentrations of nalbuphine have significant effects on the use of propofol in children gastroscopy,and nalbuphine at doses of 0.15 mg/kg combined with a suitable dose of propofol has good anesthetic effect and safety.