摘要
目的比较不同剂量阿芬太尼复合丙泊酚在胃镜检查中的应用效果,分析胃镜检查的适宜用药方案,以提高胃镜检查的有效性和安全性。方法选取2021年9月—2022年3月在晋江市医院行无痛胃镜检查的90例患者,用随机数字法分为三组,每组30例。A组丙泊酚(2 mg/kg)+阿芬太尼1μg/kg,B组丙泊酚(2 mg/kg)+阿芬太尼5μg/kg,C组丙泊酚(2 mg/kg)+阿芬太尼10μg/kg。记录检查过程中追加使用丙泊酚、体动、呛咳、丙泊酚注射痛、检查时间、入睡时间和苏醒时间;同时记录检查前(T1)、检查结束(T2)、检查结束5 min(T3)和检查结束10 min(T4)患者的心率(heart rate,HR)、平均动脉压(mean artery pressure,MAP)和血氧饱和度(oxygen saturation,SpO_(2))的变化情况及不良反应。结果三组患者检查过程中呛咳、体动、追加使用丙泊酚和丙泊酚注射痛发生率比较,差异均有统计学意义(P<0.05);三组患者入睡时间比较差异有统计学意义(P<0.05),而苏醒时间比较差异无统计学意义(P>0.05);与T1比较,T2时各组的SpO_(2)明显升高,差异有统计学意义(P<0.001),A组患者在T4时的HR明显降低,差异有统计学意义(P<0.001),B组和C组患者在T2、T3、T4时的HR明显降低,差异有统计学意义(P<0.05);B组患者各时点MAP均明显低于A组,差异有统计学意义(P<0.05),各组T2、T3、T4的MAP与T1比较均明显降低,差异有统计学意义(P<0.001);三组术后均未发生严重不良反应。结论丙泊酚(2 mg/kg)复合5μg/kg阿芬太尼用于胃镜检查,能够满足医生的操作,患者循环波动小,丙泊酚注射痛发生率低,检查结束苏醒质量好。
Objective To explore the effect of different doses of alfentanil combined with propofol in gastroscopy and explore the optimal dosage of propofol combined with alfentanil,improve the safety of painless gastroscopy.Methods A total of 90 patients were randomly divided into three groups,with 30 patients in each group:propofol(2 mg/kg)+alfentanil 1μg/kg(group A),propofol(2 mg/kg)+alfentanil 5μg/kg(group B),propofol(2 mg/kg)+alfentanil 10μg/kg(group C).The additional use of propofol,body movement,cough,pain caused by propofol injection,examination time,time to fall asleep,time to wake up during the examination,the changes of heart rate(HR),mean artery pressure(MAP),oxygen saturation(SpO_(2))before examination(T1),at the end of examination(T2)and 5 minutes after examination(T3)and 10 minutes after examination(T4)and complications were recorded during the examination.Results There were significant differences in the incidence of cough,body movement,additional use of propofol and propofol injection pain among the three groups(P<0.05).There was a statistically significant difference in the time of falling asleep among the three groups(P<0.05),while there was no statistically significant difference in the time of awakening(P>0.05).Compared with T1,SpO_(2) in each group at T2 was significantly higher,and the difference was statistically significant(P<0.001),HR in group A at T4 was significantly lower,and the difference was statistically significant(P<0.001),HR in group B and C at T2,T3,T4was significantly lower,and the difference was statistically significant(P<0.05).MAP in group B was significantly lower than that in group A at all time points,and the difference was statistically significant(P<0.05),and MAP in T2,T3,T4 in each group was significantly lower than that in T1,and the difference was statistically significant(P<0.001).No serious complications occurred in the three groups.Conclusion Propofol(2 mg/kg)combined with 5μg/kg fentanyl for gastroscopy can meet the requirements of doctors’operation,patients’circulation fluctuation is small,the incidence of propofol injection pain is reduced,and the quality of recovery after examination is good.
作者
刘小红
卢清旺
张清福
LIU Xiaohong;LU Qingwang;ZHANG Qingfu(Department of Anesthesiology,Jinjiang Municipal Hospital,Jinjiang Fujian 362000,China;Department of Anesthesiology,Shanghai Jiaotong University Affiliated Sixth People's Hospital,Shanghai 200233,China)
出处
《中国卫生标准管理》
2022年第18期125-129,共5页
China Health Standard Management
关键词
阿芬太尼
丙泊酚
无痛胃镜检查
静脉麻醉
舒适化医疗
门诊麻醉
alfentanil
propofol
painless gastroenteroscopy
intravenous anesthesia
comfort medicine
outpatient anesthesia
