摘要
目的比较丙泊酚复合不同阿片类药物在无痛胃镜检查中的应用效果。方法拟行无痛胃镜检查的患者120例,ASAⅠ～Ⅱ级,年龄25～60岁,体重45～75kg。随机分为3组,芬太尼组(F组)、舒芬太尼组(S组)、瑞芬太尼组(R组)每组40例。F组静脉注射芬太尼0.8μg/kg,S组静脉注射舒芬太尼0.08μg/kg,R组静脉注射瑞芬太尼0.5μg/kg,各组均静脉注射丙泊酚1～2mg/kg,意识消失时置入胃镜,术中酌情追加丙泊酚0.5～1mg/kg,观察3组患者丙泊酚用量、苏醒时间、视觉模拟评分(VAS),评价清醒时和1h后疼痛程度及不良反应的发生情况。结果与F组和S组比较,R组丙泊酚用量最少,分别为(120±14)mg、(118±18)mg及(96±15)mg(P<0.05);而R组低氧血症发生率显著增加(5%、5%vs.16%,P<0.05);与F组和R组比较,S组清醒1h后VAS评分减低,分别为5.0±0.9、5.1±0.8、4.0±1.1(P<0.05)。结论在无痛胃镜检查中0.5μg/kg瑞芬太尼组较0.8μg/kg芬太尼组和0.08μg/kg舒芬太尼组丙泊酚用量减少,但是对呼吸的抑制较舒芬太尼组和芬太尼组重。舒芬太尼组术后舒适程度优于芬太尼组及瑞芬太尼组。
Objective To compare the effect of propofol combined with suffentanil or remifentanil anesthesia on the pain -free gastroscopy. Methods 120 ASA Ⅰ or Ⅱ patients aged from 25 to 60 years old weighing 45 ～75 kg were randomly divided into 3 groups（n=40）：group F received fentanil 0.8μg/kg ;group S received suffentanil 0.08μg/kg; group R received remifentanil 0.5μg/kg.Lidocaine 20mg and propofol 1～2mg/kg were then injected i.v. slowly until consciousness was lost and eyelash reflex disappeared. in three groups. Then gastroscopy was started.Intermittent i.v. boluses of propofol 0.5～1μg/kg was given during operation when necessary. The total of propofol used for induction,awakening time, the score of VAS were observede. The level of pain at awakening and at 1 hour after awakening, and side effects were evaluated. Results There was no significant difference in the 3 groups comparabled with respect to age,sex ratio,boby weight and height.There was no significant difference in awakening time and the score of VAS at awaking. The total dose of propofol used for induction was sighnificantly lower in group R than that in group F and group S. The rate of hypoxemia increased higher in group R than that in group F and group S. The score of VAS was lower at 1 hour after awakening in group S than that in group F and group R. Conclusions The total dose of propofol used for induction is lower in 0.5μg/kg remifentanil group than that in 0.8μg/kg fentanil group and 0.08μg/kg suffentanil group. The rate of hypoxemia increase in group R than that in group F and group S. The comfortable level of group S is better than that of group F and group R.
出处
《北京医学》
CAS
2009年第10期602-604,共3页
Beijing Medical Journal
