摘要
目的观察氟马西尼对未使用咪达唑仑而使用丙泊酚的无痛胃肠镜患者苏醒过程的影响,并探讨氟马西尼是否能促进丙泊酚麻醉后认知功能的恢复。方法选择行无痛胃肠镜患者75例,年龄18～65岁,ASAⅠ或Ⅱ级,随机均分为氟马西尼0.5mg组(F1组)、氟马西尼1.0mg组(F2组)和生理盐水对照组(C组)。胃肠镜检查中使用芬太尼以及TCI丙泊酚进行麻醉,检查结束根据随机分组结果分别静脉给予氟马西尼0.5mg、1mg和10ml生理盐水。术中监测BP、HR、SpO2,记录丙泊酚总用量、内镜检查时间以及呛咳、体动、低血氧、低血压、心动过缓的发生率,检查后腹胀腹痛、恶心呕吐、寒颤等不良反应发生率。麻醉前和检查结束30min后记录简易智能精神状态检查量表(MMSE)评分和脑定向力数值以及手术应激指数(SSI)。记录三组患者检查结束睁眼时间和清醒时间。结果三组患者内镜检查时间、丙泊酚总量差异无统计学意义。三组患者检查结束睁眼时间和清醒时间差异无统计学意义。三组患者检查结束MMSE评分、脑定向力数值及SSI与麻醉前比较差异无统计学意义,组间比较差异无统计学意义。结论本研究未观察到氟马西尼可加速丙泊酚麻醉苏醒过程。无痛胃肠镜操作后使用氟马西尼拮抗丙泊酚麻醉残余作用尚缺乏证据支持。
Objective To investigate the effects of flumazenil on recovery and cognitive function in patients who were given propofol underwent painless gastroenterological endoscopy. Methods Seventy-five patients （aged 18 to 65 years, ASA I or H ） scheduled for elective painless gastroenterologieal endoscopy were randomly given flumazenil 0.5 mg （group F1）, flumazenil 1.0 mg （group F2）, or normal saline （group C） intravenously after procedure. Anesthesia during procedure was maintained by fentanyl and TCI propofol infusion. BP, HR and SpO2 were monitored. The dosage of propofol, time of examination and incidence rates of bucking, body movement, hypoxemia, hypotension, bradycardia were recorded. The side effects such as bellyache, nausea and vomiting, shiver were also recorded. Cognitive function was assessed by the Mini-Mental State Examination （MMSE） and multi functional electroencephalography before and 30 minutes after the procedure. The eye-opening lime and waking time were recorded. Results The time of endoscopy, and total propofol consumption were comparable among three groups. Neither the recovery time including the eyeopening time and waking time nor the cognitive function such as MMSE scores, brain orientation index and SSI after the procedure revealed significant different among three groups. Conclusion Application of flumazenil could not decrease the recovery time or improve the cognitive function in patients for painless gastroenterological endoscopy procedure.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2013年第2期121-123,共3页
Journal of Clinical Anesthesiology
关键词
氟马西尼
丙泊酚
无痛胃肠镜
催醒作用
认知功能
Flumazenil
Propofol
Painless gastroenterologicai endoscopy
Analeptic effect
Cognitive function
