摘要
目的观察RugLoop程序监控下异丙酚复合瑞芬太尼靶控输注(TCI)用于无痛胃镜下胃息肉切除术的效果和安全性。方法将60例行无痛胃镜下胃息肉切除术的患者随机均分为两组,其中P组在RugLoop程序监控下予异丙酚TCI以2.0μg/mL效应室药物浓度为初始靶浓度;PR组以血浆浓度1.0 ng/mL瑞芬太尼TCI维持镇痛,随后同上复合异丙酚靶控镇静。记录不同时间点脑电双频指数(BIS)、SpO2、呼吸频率(RR)、平均动脉压(MAP)、HR及异丙酚耗量、术毕苏醒时间、术后遗忘发生率、镇静满意度、不良反应发生情况。结果除P组1例因严重呛咳剔除研究外,余59例均完成胃镜下胃息肉切除手术,胃镜操作时间无统计学差异(P>0.05)。PR组手术开始3、6和9 min的RR、BIS显著低于P组,异丙酚耗量及术毕苏醒时间均显著少于P组(P<0.05或<0.01);两组镇静满意度、术后遗忘发生率及不良反应发生率无统计学差异(P均>0.05)。结论 RugLoop程序监控下异丙酚复合瑞芬太尼TCI用于无痛胃镜下胃息肉切除术,具有镇静、镇痛效果满意,异丙酚用药量减少、术毕唤醒时间短等优点。
Objective To investigate the efficacy and safety of propofol-remifentanil given by target-controlled infusion( TCI) in gastric polyps resection during painless gastroscopy with RugLoop program. Methods Sixty patients( ASA I or Ⅱ) receiving gastric polyps resection in painless gastroscopy were randomly divided into two groups,30 cases in each group: group P and group PR. In the group P,with RugLoop program,patients were treated with propofol TCI by taking 2 μg /mL effect site concentration of propofol as the initial target concentration; in the group PR,remifentanil TCI with plasma concentration of 1 ng / mL was used for analgesia,and at the same time propofol( 10 mg / mL) was combined for sedation. Propofol given method was similar to that of group P. Bispectral index( BIS),SpO 2,RR,mean arterial pressure( MAP),HR,total propofol consumption,rate of amnesia,awakening time after operation,and rate of adverse events were separately recorded as well as the physician and patient satisfaction. Results In the group P,59 patients( 98. 3%) undergoing gastric polyps resection were successful,and no significant difference in the operation time was found( P > 0. 05). The RP,BIS values at time points of 3 min,6 min and 9 min in the group PR were significantly lower than those of group P as well as the total propofol consumption and awakening time after operation( P < 0. 05,P < 0. 01). No significant differences were found in the physician and patient satisfaction and rate of amnesia and adverse events between the two groups( P >0. 05). Conclusion Propofol combined with remifentanil TCI in gastric polyps resection during painless gastroscopy with RugLoop program has the effect of sedation and analgesia,reduces the propofol dosage,shortens the postoperative awaking time and improves the safety.
出处
《山东医药》
CAS
2013年第45期16-19,共4页
Shandong Medical Journal
基金
2008年济南市卫生局科技项目计划(2008-10-2)
关键词
麻醉
静脉
靶控输注
异丙酚
瑞芬太尼
胃镜
intravenous anesthesia
target-controlled infusion
propofol
remifentanil
gastroscopy
