纳布啡对成年女性无痛胃镜检查中丙泊酚注射痛的影响

伍观嫦 李永程 袁桂婵

【摘要】目的：本研究探討纳布啡预处理对成年女性无痛胃镜检查中丙泊酚注射痛的影响。方法：选择2020年6月至2021年1月期间在本院门诊行无痛胃镜检查成年女性患者100例，ASA分级为Ⅰ～Ⅱ级，年龄19～60岁，BMI 18～25 kg/m2，随机分为纳布啡组（N组）和对照组（C组），每组50例。N组患者在麻醉诱导前静脉注射纳布啡5mg，C组患者静脉注射等容量生理盐水。10 min后嘱两组患者取左侧卧位后行静脉麻醉，两组患者静脉注射丙泊酚2.5mg/kg，待睫毛反射消失便开始行胃镜检查，如检查过程出现明显体动反应则追加丙泊酚1 mg/kg。评估两组患者丙泊酚注射痛发生情况进行；记录两组患者丙泊酚使用总量、检查过程出现呛咳、呼吸抑制、低血压、心动过缓等不良事件发生率；记录两组患者苏醒时间、苏醒后10 min、30 minRamsay镇静评分。结果：N组患者注射痛发生率较C组明显降低（P<0.05），N组患者丙泊酚使用总量较C组明显降低（P<0.05），两组患者检查过程呛咳、呼吸抑制、低血压、心动过缓发生率比较差异无统计学意义（P>0.05），两组患者苏醒时间、苏醒后10 min、30 minRamsay镇静评分比较差异无统计学意义（P>0.05）。结论：使用纳布啡预处理能降低无痛胃镜检查时丙泊酚注射痛发生率，降低丙泊酚用量，但不延长苏醒时间，不降低苏醒质量。

【关键词】纳布啡；成年女性；无痛胃镜；丙泊酚；注射痛

[中图分类号]R614 [文献标识码]A [文章编号]2096-5249（2021）13-0016-03

Effect of nalbuphine on propofol injection pain in adult women undergoing painless gastroscopy

WU Guan-chang1， LI Yong-cheng2， YUAN Gui-chan1（1. Dongguan Dongcheng hospital， Dongguan Guangdong 523430， China； 2. Dongguan maternal and child health hospital， Dongguan Guangdong 523430， China）

[Abstract] Objective： This study was to investigate the effect of pretreatment with nalbuphine on propofol injection pain in adult women undergoing painless gastroscopy. Methods： 100 adult female patients undergoing painless gastroscopy in the outpatient department of our hospital were selected. They were ASA grade I-II， aged 19-60 years， and BMI 18-25 kg/m2. They were randomly divided into group N and group C， with 50 cases in each group. Before anesthesia induction， patients in group n were injected with 5 mg of nalbuphine intravenously， while patients in group C were injected with the same volume of normal saline intravenously. After 10 minutes， the patients in the two groups were asked to take the left supine position for intravenous anesthesia. The patients in the two groups were injected with propofol 2.5 mg/kg intravenously. Gastroscopy was started when the eyelash reflex disappeared. If there was obvious body movement reaction during the examination， propofol 1 mg/kg was added. Results： The incidence of injection pain in group N was significantly lower than that in group C （P<0.05）， and the total amount of propofol used in group N was significantly lower than that in group C （P<0.05）. There was no significant difference in the incidence of cough， respiratory depression， hypotension and bradycardia between the two groups （P>0.05）. The recovery time， 10 minutes and 30 minutes after recovery in the two groups There was no significant difference in Ramsay Sedation score （P>0.05）. Conclusion： Pretreatment with nalbuphine can reduce the incidence of propofol injection pain during painless gastroscopy， reduce the dosage of propofol， but does not prolong the recovery time， does not reduce the quality of recovery.[Key word] Nalbuphine； Adult female； Painless gastroscopy； Propofol； Injection pain

胃镜检查是上消化道疾病最常用的检查方法，通过检查可明确多种上消化道病变，如食管癌、胃癌等，检查前患者先口服表面麻醉药物如达克罗宁等，检查时患者清醒，绝大多数患者检查时候有较明显不适感且伴有恶心呕吐，甚至部分患者无法耐受检查，影响检查操作顺利完成或对胃镜检查产生恐惧焦虑情绪[1-4]。……