摘要
目的对瑞芬太尼复合丙泊酚在胃镜检查中的镇静效果和安全性进行研究。方法选择ASAⅠ～Ⅱ级90例胃镜检查患者,随机分成三组,即丙泊酚组(A组)、芬太尼复合丙泊酚组(B组)和瑞芬太尼复合丙泊酚组(C组),每组30例。术中在置入胃镜前、胃镜经咽时、镜检时及镜检后5min各时点监测HR、MAP、SpO2等。记录镇静起效时间、定向力恢复时间、镜检满意度、术中知晓、胃镜操作时间及不良反应。结果B组在置入胃镜前、胃镜经咽时、镜检时及镜检后5min各时点HR明显减慢(P<0.05),A组在胃镜经咽时、镜检时HR明显增快(P<0.05)。B组MAP较A组和C组明显降低(P<0.05)。检查过程中A组和B组低血压发生率较C组明显增高(P<0.05)。A组和B组注药时静脉疼痛及术后头晕发生率较C组明显增高(P<0.05)。A组肢体扭动和呛咳等不良反应发生率较B组和C组明显增高(P<0.01)。结论胃镜检查中采用瑞芬太尼和丙泊酚联合镇静,起效时间快、定向力恢复时间短、镜检满意度高、丙泊酚用量明显减少、费用更低、副作用少,且镇静效果增强,是一种安全、有效的方法。
Objective To study the sedative effect and safety of propofol combined with remifentanfl in intravenous anesthesia for gastroscopy, Methods Ninety patients with ASA Ⅰ～Ⅱ were divided into three groups randomly：group A （propofol group）, group B （fentanyl combined with propofol group） and group C （remifentanil combined with propofol group）.HR, MAP, SpO2 etc were respectively monitored. At four different moments：before the placement of the gastroscope, when it goes through the throat, during and 5 minutes after the gastroscopy. Record the time to onset of sedation, the time of regaining orientation, the patients-conseiousness and satisfaction, the operating time of gastroscope and adverse reactions. Results HR was significantly slower in group B（P〈0.05） at these four different moments. HR was significantly faster in group A（P〈0.05） when the gastroseope goes through the throat and during the gastroscopy. Compared with group A and group C, group B shows a significant decline in MAP（P〈0.05）.Group A and group B show significantly higher rates of hypotension than group C during the gastroscopy（P〈0.05）. Group A and group B show significantly higher rates of vein pain during infusion and dizziness after gastroscopy than group C（P〈0.05）.Group A shows significantly higher rates of aderse effects such as body wriggle and bucking etc than group B and group C（P〈0.01）. Conclusion Propofol combined with remifentanil in intravenous anesthesia for gastroscopy has a rapid, safe and effective sedation with less dosage ofpropof, lower cost and fewer side effects.
出处
《当代医学》
2010年第6期74-75,共2页
Contemporary Medicine
关键词
丙泊酚
瑞芬太尼
靶控输注
胃镜检查
镇静
Propofol
Remifentanil
Target controlled infusion（TCI）
Gastroscopy
Sedation
