丙泊酚复合小剂量舒芬太尼用于无痛胃镜临床观察

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1、丙泊酚复合小剂量舒芬太尼用于无痛胃镜临床观察作者：孙彭龄，李永华，宋泽明，袁红斌【摘要】目的探讨丙泊酚复合舒芬太尼用于门诊无痛胃镜的安全性和有效性。方法ASAⅠ-Ⅱ级要求行门诊无痛胃镜检查的患者120例，随机分为3组，即分为丙泊酚+生理盐水组(P组)、丙泊酚复合芬太尼组(PF组)和丙泊酚复合舒芬太尼组(PS组)，每组40例。各组在静脉注射丙泊酚前分别静脉注射生理盐水2ml、芬太尼0.5mg、舒芬太尼0.1μg/kg，待患者睫毛反射消失后插入胃镜，检查过程中连续监测HR、MAP、SpO2，记录丙泊酚的总量、意识恢复时间、定向力恢复时间、胃镜操作时间、术中知

2、晓发生率等，观察注药时静脉疼痛、胃镜检查中呛咳、体动反应、头晕的情况。结果三组患者术中HR、MAP、SpO2与术前或术后相比均明显降低(P<0.05)，各组之间HR、MAP、SpO2比较差异均有统计学意义(P<0.05),意识恢复时间、定向力恢复时间P组与PF、PS组相比明显延长，差异具有统计学意义(P<0.05)，PF、PS组之间也有统计学意义(P<0.05)。丙泊酚用量P组比PF、PS组增加，差异具有统计学意义(P<0.05)，PF、PS组之间无统计学差异。结论丙泊酚复合小剂量舒芬太尼(0.1μg/kg)不仅可以减少丙泊

3、酚用量、有效降低呼吸抑制等副反应，而且能缩短苏醒时间，使麻醉更加平稳。9【关键词】胃镜检查；麻醉；二异丙酚；舒芬太尼Abstract：ObjectiveToevaluateefficacyandsafetyofpropofol-sufentanylappliedtoanesthesiaofgastrofiberscopy.MethodsOnehundredandtwentypatientsscheduledforelectivegastrofiberscopywererandomizedintothreegroups.GroupP(n=40)wasgiv

4、enintravenousnormalsaline(2ml)beforeadministrationofpropofol,GroupPF(n=40)givenintravenousfentanyl(0.5mg)andthenpropofol,andGroupPS(n=40)givenintravenoussufentanyl(0.1μg/kg)andthenpropofol.Gastrofiberscopywasinsertedaftereyelashesreflexhadbeenextinct.Theparameters,suchasHR,MAP,Sp

5、O2,totaldoseofpropofol,recoveringtimeofconsciousnessandorientation,andawarenesstimeduringoperation,wererecorded.Painfromtheinjectionofpropofol,coughandbody-movementoccurrenceintheoperationwereobserved.ResultsMAP,HRandSpO2wereobviouslylowerinoperationthaninpreoperationorpostoperat

6、ionineachgroup(P<0.05)andwereofsignificantdifferenceamongallthegroups(P<0.05).TherecoveringtimeofconsciousnessandorientationwassignificantlylongerinGroupPthaninGroupPForPS,andtherewassignificantlydifferencebetweenGroupPFandGroupPS(P<0.05).TotaldoseofpropofolinGroupP9wass

7、ignificantlylargerthanthatinGroupPForPS(P<0.05).ConclusionThecombinationofpropofolwithsufentanylappliedtotheoperationofgastrofiberscopycanprovidesatisfactoryanesthesiaeffectswithadvantageoflowerdoseofpropofol,lessrespiratorydepressionandrapidrecoveryafteroperation.Keywords：gas

8、troscopy;anesthesia;propofol;sufentanyl胃