摘要
目的研究丙泊酚-瑞芬太尼靶控输注用于老年患者无痛肠镜检查的安全性、有效性及可行性。方法将67例门诊及住院需要肠镜检查的老年患者随机分为A组(34例)及B组(33例);A组采用丙泊酚-瑞芬太尼靶控输注,丙泊酚血浆靶控浓度为0.5～1.0!g/ml、瑞芬太尼血浆靶控浓度0.5～1.0ng/ml同时靶控输注;B组常规操作。RamsayⅡ级开始插镜,抵达回盲部停止给药。分别记录术前、进镜至回盲部及检查完毕SBP、DBP、HR、SpO2值及不良反应发生的例数。结果Ramsay评分A组Ⅱ级97.1%,B组Ⅰ级100%(P<0.01);进镜至回盲部过程:A组SBP、DBP、HR无明显变化,B组明显高于术前,与A组有显著性差异(P<0.05);A组体动及呻吟明显少于B组(P<0.01);A组操作成功率及患者满意度明显高于B组(P<0.01);A组无呼吸抑制发生。结论老年患者应用丙泊酚-瑞芬太尼靶控输注麻醉效果好,血流动力学稳定,肠镜操作成功率高,患者的耐受性好,是一种安全、有效、可行的无痛肠镜麻醉方法。
Aim To investigate the safety, validity and feasibility of target-controlled infusion of propofol plus remifentanfl on senile patients with painless colonoscopy. Methods Sixty seven senile patients scheduled for colonoscopy were randomly divided into 2 groups： group A included 34 patients and the control group （group B） 33 patients. Patients in group A was given traget-controlled infusion ofpropofol plus remifentanil. During the examination the propofol was maintained at a target plasma concentration of 0.5 - 1.0 μg/ml, and remifetanil of 0.5 - 1.0 ng/ml at the same time. Patients in group B underwent routine performance. Colonoscope inserting began when patients achieved Ramsay score II, and stopped infusion when colonoscopy reached ileocecal region. SBP, DBP, HR, SpO2 and the adverse reactions before, during and after the examination were recorded. Results The patient achieved Ramsay score of 2 on the group A was 97.1%, and the group B achieved Ramsay score of Ⅰ was 100% （P 〈 0.01）. The level of SBP, DBP and HR had no significant changes during the colonoscopy in group A, but in group B, significant higher levels of SBP, DBP and HR were observed during the examination （P 〈 0.05）. Compared with group B, patients in group A has lesser body movements and groan （P 〈 0.01）, and higher technical success rate and satisfaction （P 〈0.01）. There was no respiratory depression in group A. Conclusion The present study suggests that the target-controlled infusion of propofol plus remifentanil in senile patients has good anesthetic effect, steady hemodynamics, the higher technical success rate and well toleration. It is a safe, effective, reliable and painless anesthetic method in colonoscopy.
出处
《现代消化及介入诊疗》
2008年第3期164-167,共4页
Modern Interventional Diagnosis and Treatment in Gastroenterology
关键词
肠镜
老年人
丙泊酚-瑞芬太尼
靶控输注
Colonoscopy
Senile patients
Propofol plus remifentanil
Traget-controlled infusion
