摘要
目的:探讨丙泊酚复合小剂量咪唑安定、芬太尼麻醉应用于无痛胃镜检查的可行性。方法:200例ASAⅠ～Ⅲ级患者分为无痛胃镜组(Ⅰ组n=100)和常规胃镜组(Ⅱ组n=100)。Ⅰ组从静脉缓慢注入咪唑安定0.03mg/kg、芬太尼0.4μg/kg和丙泊酚1～1.5mg/kg,直至患者睫毛反射消失即可置入胃镜;Ⅱ组按常规方法进行胃镜检查;专人评估患者的术中和术后恢复情况及术后调查结果。结果:胃镜检查完成率Ⅰ组高于Ⅱ组(100%;91%)。Ⅰ组在检查5min时SBP、MAP、HR比检查前明显下降(P<0.05),Ⅱ组的SBP、MAP比检查前明显增加(P<0.05),术毕均恢复至术前水平;Ⅰ组患者术毕至清醒和离开观察室的时间分别为(6.30±2.40)min、(17.40±4.50)min;Ⅰ组的患者、检查者、记录者的满意度评分和再次检查可接受率明显高于Ⅱ组(P<0.05)。结论:丙泊酚复合小剂量咪唑安定、芬太尼麻醉实施无痛胃镜检查是安全可行的。
Objective： To study the applicability and side effects of propofol combined with low dose midazolam and fentanyl in patients undergoing gastroscopy. Methods：200 ASA Ⅰ～Ⅲ patients undergoing gastroscopy were randomly divided into analgesia group （ Ⅰ ）and control group（ Ⅱ ）. In group Ⅰ （n= 100）, propofol 1 ～ 1.5mg/kg, Midazolam 0. 03mg/kg, Fentanyl 0. 4μg/kg were given intravenously slowly, gastroscope was inserted till loss of lid relax occurred. Group Ⅱ （n= 100）, patients received regular gastroscopy. SBP MAP and HR were measured during operation and after operation. Results：Successful rate of gastroscopy in group I （100%0）was higher than in group Ⅱ （91%）. In group Ⅰ SBP MAP and HR at the fifth minute after operation were significantly decreased compared with pre-operation values（P〈0. 05）. In group Ⅱ SBP MAP and HR were significantly increased compared with pre-operation values（P〈0.05）. In the two groups SBP MAP and HR returned normal after operation. Recovery time and Leaving time were （ 6.30 ± 2.40） min and （ 17.45 ± 4. 50） min respectively. In group Ⅰ , the satisfiable score and acceptable rate of next gastroscopy were singnificantly higher than in group Ⅱ （P〈0.05）. Conclusions：Propofol combined with low dose Midazolam and Fentanyl is applicable and safe in analgesia gastroscope.
出处
《中国冶金工业医学杂志》
2005年第6期604-605,共2页
Chinese Medical Journal of Metallurgical industry
关键词
复合麻醉
胃镜检查
镇静术
Combind anesthesia Gastroscopy Sedation
