不同剂量布托啡诺复合丙泊酚靶控输注在老年患者结肠镜检查中的比较

目的 观察不同剂量布托啡诺复合丙泊酚靶控输注在老年患者纤维结肠镜检查中的可行性和安全性.方法 选择ASA Ⅰ～Ⅱ级结肠镜检查老年患者160例,随机分成4组,一组为对照组,使用丙泊酚复合芬太尼1.0μg/kg（F组）,另外3组复合使用布托啡诺,分为布托啡诺10μg/kg组（B10组）,布托啡诺15μg/kg组（B15组）和布托啡诺20μg/kg组（B20组）,每组40例.4组丙泊酚血药浓度3.0μg/ml靶控输注.观察麻醉前后患者循环变化、麻醉质量评分以及不良反应.结果 4组患者无痛结肠镜检查都顺利完成,各组结肠镜检查后MAP、HR均有不同程度的下降,以F组为著（P〈0.05）,B20组丙泊酚用量明显减少（P〈0.05）,但苏醒时间延长.4组麻醉优良率无明显差异,不良反应发生率都在可接受范围.结论 布托啡诺10~15μg/kg复合靶控输注丙泊酚在老年患者结肠镜手术麻醉中血流动力学相对稳定,无明显不良反应,安全有效.

Different dose of butorphanol combined with propofol target-controlled infusion in elderly patients with colonoscopy

Objective To observe the feasibility and safety of the different dose of butorphanol combined with propofol target-controlled infusion in elderly patients with colonoscopy. Methods Selected 160 cases elderly patients of ASA I - II level, randomly divided into 4 groups,the control group using propofoll composite fentany 1.01μg/kg （F group）, three other groups of compound using butorphanol,divided into butorphanol 10μg/kg group （Bl0 group）, butorphanol 15μg/kg group （B1s group） ,butorphanol 20μg/kg group （B20 group） ,each group 40 cases. Four groups of blood concentration of propofol target con- trolled infusion was 3.0μg/ml. The changes of respiratory and circulatory function,anesthesia quality scoring,and side- effects were observed before and after anesthesia. Results 4 groups of patients with painless colonoscopy were successfully complet- ed,circulatory depression to a certain extent after anesthesia,and the most one was group F （P〈0.01）. B20 group of dosage propofol obviously reduced （P〈O.05） ,but waking time extended. The anesthesia excellent rates of four groups were no obvious differences. The incidence of adverse reactions were in the acceptable range. Conclusion Butorphanol 10-15μg/kg combined with target-controlled infusion of propofol in elderly patients with colonoscopy anesthesia is relatively stable and no significant side effects. It is safe and effective.