摘要
目的观察电针联合丙泊酚应用于无痛肠镜检查的临床效果,探讨电针用于临床无痛肠镜检查的安全性和有效性。方法选择自愿接受无痛肠镜检查的门诊患者120例,男64例,女56例,年龄25~75岁,BMI 18~28 kg/m2,ASAⅠ或Ⅱ级。根据患者意愿分为电针联合丙泊酚组(E组)、瑞芬太尼复合丙泊酚组(R组)和单纯丙泊酚组(P组),每组40例。患者取左侧卧位,E组在丙泊酚麻醉诱导前接受电针疗法,R组采用瑞芬太尼复合丙泊酚静脉麻醉,P组采用单纯丙泊酚静脉麻醉。记录给药前(T0)、睫毛反射消失时(T1)、过脾曲时(T2)、过肝曲时(T3)和镜检完成时(T4)的HR和MAP,以及术中丙泊酚的追加量和总用量、术中体动次数、术后腹痛评分、诱导时睫毛反射消失时间、术后唤醒时间和定向力恢复时间等。记录术后呼吸抑制、恶心呕吐、低血压、心动过缓、低氧血症等不良反应的发生情况。结果与T0时比较,T1时R组HR明显减慢(P<0.05),MAP明显降低(P<0.05)。E组和R组术中丙泊酚追加量和总用量明显低于P组,体动次数明显少于P组(P<0.05),但E组和R组差异均无统计学意义。三组术后腹痛评分差异无统计学意义。E组和R组术后麻醉唤醒时间和定向力恢复时间均明显短于P组(P<0.05),但E组和R组差异无统计学意义。三组诱导时睫毛反射消失时间差异无统计学意义。三组术后呼吸抑制、恶心呕吐、低血压、心动过缓和低氧血症等不良反应发生率差异均无统计学意义。结论相较于单纯应用丙泊酚或瑞芬太尼复合丙泊酚麻醉,电针联合丙泊酚能够更好地为肠镜检查患者提供有效的镇痛效果。
Objective To investigate the safety and efficacy of electroacupuncture combined with propofol in painless enteroscopy. Methods A total of 120 outpatients, 64 males and 56 females, aged 25-75 years, BMI 18-28 kg/m2, falling into ASA physical status Ⅰ-Ⅱ, were randomly allocated into three groups(n = 40 for each group). All the patients were treated by painless enteroscopy. Group E received electroacupunture before induction of propofol anesthesia. Group R received remifentanil combined with propofol intravenous anesthesia. Group P received intravenous anesthesia with propofol only. The changes of HR and MAP were continuously monitored and recorded on pre-operation(T0), loss of eyelash reflex(T1), splenic curvature(T2), liver curvature(T3) and post-enteroscopy(T4). The number of body movements during operation, the additional and total dosage of propofol, time of anesthetic wake-up, recovery time of directional force, incidence of adverse reactions such as respiratory depression, nausea and vomiting, postoperative pain score were recorded. Results The HR and MAP of group R at T1 were significantly lower than those at T0(P < 0.05). In group E and group R, the number of body movements, the additional and the total dosage of propofol were significantly lower than those in group P(P < 0.05). The time of anesthetic wake-up and recovery time of directional force with in group E and group R were significantly reduced compared with group P(P < 0.05). And there was no significant difference between group E and group R in the above indicators. There was no significant difference between the three groups in the incidence of adverse reactions. Conclusion Compared with propofol or remifentanil combined propofol, the electroacupuncture combined with propofol could providebetter analgesic effect for patients undergoing colonoscopy.
作者
郑俊飞
陆晔
陈志勇
吴丹
张家敏
朱美华
ZHENG Junfei;LU Ye;CHEN Zhiyong;WU Dan;ZHANG Jiamin;ZHU Meihua(Department of Anesthesiology,the Second Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210017,China)
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2019年第9期874-877,共4页
Journal of Clinical Anesthesiology
基金
江苏省中医药局科技项目(YB201822)
关键词
电针
无痛肠镜
丙泊酚
瑞芬太尼
Electroacupuncture
Painless enteroscopy
Propofol
Remifentanil
