摘要
目的比较不同浓度丙泊酚复合瑞芬太尼,以及麻黄素的使用在老年患者无痛肠镜检查的效果和安全性。方法60例行无痛肠镜检查老年患者,年龄65～83岁,ASAⅠ～Ⅲ级,随机分为3组:Ⅰ组:1%丙泊酚复合瑞芬太尼组;Ⅱ组:0.5%丙泊酚复合瑞芬太尼组;Ⅲ组:麻黄素、0.5%丙泊酚复合瑞芬太尼组。3组患者均静脉注射瑞芬太尼10μg,Ⅲ组患者预先注入麻黄素2～3mg,Ⅰ组静脉注射1%丙泊酚,Ⅱ、Ⅲ组静脉注射0.5%丙泊酚直到病人入睡,睫毛反射消失后开始行肠镜检查,术中追加剂量为每次丙泊酚2～3ml。观察病人麻醉前、麻醉后3min,术毕MAP、HR和SpO2;异丙酚的总用量;呼吸暂停、面罩加氧、体动次数和苏醒时间,低血压、心动过缓、注射痛、恶心呕吐发生率、患者满意度和术者满意度。结果麻醉后3minⅠ、Ⅱ组患者MAP和HR明显下降(P<0.05),Ⅲ组患者无明显下降。Ⅰ组患者呼吸暂停、面罩加氧次数超过Ⅱ、Ⅲ组(P<0.05)。3组患者SPO2无明显变化。Ⅱ、Ⅲ组患者苏醒时间快(P<0.01);异丙酚总用量少(P<0.01)。Ⅲ组低血压和心动过缓发生率低(P<0.05或P<0.01)。3组患者满意度和术者满意度及注射痛、恶心呕吐无统计学差异(P>0.05)。结论小剂量麻黄素、0.5%丙泊酚复合瑞芬太尼对老年无痛肠镜患者呼吸循环影响小,可控性好,术中不良反应少,可以较好地用于老年患者无痛肠镜检查。
Objective To compare the clinical efficacy and safety of different concentrations of propofol combined with remifentanil, or with ephedrine in old patients undergoing colonoscopy. Methods Sixty patients aged 65 to 83 years old scheduled to colonoscopy, ASAⅠ～Ⅱ,were randomly allocated into three groups. Patients received 1% propofol and 10μg remifentanil in Group Ⅰ , 0.5% propofol and 10μg remifentanil in group Ⅱ and Ⅲ. Only ephedrine 2 -3 mg were administered in group Ⅲ before colonoscopy. The subsequent doses of propofol were 2 - 3ml when body movement appeared. Mean arterial pressure, SpO2 and heart rates before anesthesia induction, three minutes after induction and end of colonoscopy, the total consumption of propofol,times to be conscious, the satisfacory levels of patients and doctors were recorded. And side effects as apnea, mask supported respiration, hypotension, bradycardia, body movement, transfusion pain, nausea and vomiting were also recorded. Results Mean arterial pressure and heart rates decreased significantly in group Ⅰand Ⅱ , while changed little in group m three minutes after induction. The times of apnea and mask supported respiration were more in group I than group Ⅱ and Ⅲ. The time to be conscious was shorter in group Ⅱand Ⅲ. And the total consumption of propofol was also fewer. The incidences of hypotension and bradycardia were much lower in group Ⅲ. There was no significant difference in transfusion pain, nausea and vomiting, satisfacory levels of patients and doctors among the three groups. Conclusion Small dose of ephedrine and 0.5% propofol combined with remifentanil have little influence on respiratory and circulation. It has fewer side effects and could be used in old patients undergoing colonoscopy.
出处
《医学研究杂志》
2013年第1期139-141,共3页
Journal of Medical Research
关键词
麻黄素
丙泊酚
瑞芬太尼
肠镜
Ephedrine
Propofol
Remifentanil
Colonoscopy
