摘要
目的观察依托咪酯（0.1 mg/kg）与丙泊酚（0.1 mg/kg）混合液联合芬太尼在无痛胃镜中的使用,并与单纯应用丙泊酚比较。方法选择择期行无痛胃镜检查的患者400例,美国麻醉医师协会（American Society of Anesthesiology,ASA）Ⅰ-Ⅲ级,年龄18-60岁。随机均分为丙泊酚组（P组）以及依托咪酯与丙泊酚混合液组（EP组）。所有患者在胃镜检查前2 min予以芬太尼（0.5μg/kg）缓慢静脉注射,胃镜检查前P组予以首剂1%丙泊酚（0.1 ml/kg）、EP组予以首剂丙泊酚依托咪酯混合液（0.1 ml/kg）缓慢静脉注射,根据患者镇静深度单次予以1-2 ml追加。所有患者入室后持续监测心率、无创血压及血氧饱和度。记录所有患者的药物起效时间、检查操作时间、苏醒时间以及离开胃镜室时间等指标。并记录低氧、低血压、注射痛、肌颤、恶心呕吐等不良事件,记录胃镜操作者、麻醉医师满意度以及术后1周患者满意度。结果 EP组围术期低血压、低血氧饱和度、注射痛发生率较P组显著低,两组比较差异具有统计学意义（P〈0.01）;两组患者的操作时间,苏醒时间,出室时间、出室前视觉模拟评分法（visual analogue scale,VAS）值及术后恶心、呕吐发生率,两组比较差异无统计学意义（P〉0.05）。胃镜操作者满意度EP组优于P组,两组比较差异具有统计学意义（P〈0.05）;麻醉医师满意度EP组显著优于P组,两组比较差异具有统计学意义（P〈0.01）;患者满意度两组比较差异无统计学意义（P〉0.05）。结论依托咪酯丙泊酚混合液在无痛胃镜检查术中对呼吸、循环影响较小,较单纯丙泊酚更具优势。
Objective To observe the usage of etomidate（0.5 mg/kg）plus propofol（0.5 mg/kg）mixture in painless gastroscopy and compare it with the pure propofol.Methods A total of 400 patients were randomly divided into propofol group（group P）and etomidate plus propofol group（group EP）.Group P was given the first dose of 1% propofol（1 mg/kg）before gastroscopy and group EP was given 1% propofol plus etomidate mixture 0.1 mg/kg.Repeated doses of 10-20 mg propofol or 5-10 mg propofol plus etomidate 1-2 mg were administered to maintain an adequate level of sedation.Results Group EP had a lower incidence of systolic hypotension（13.0% vs.32.5%,P〈0.0001）,bradycardia（8.5% vs.16.5%,P=0.0226）,mild hypoxemia（6.5%vs.18.0%,P=0.0007）and severe hypoxemia（2.5%vs.10.0%,P=0.0031）compared to group P.The satisfaction of anesthetist and gastroscopist in group EP was higher than that of group P（P〈0.0001 and0.018,respectively）.Conclusion Etomidate plus propofol has few effects on respiration and circulation in patients undergoing painless gastroscopy,and is more safe and effective than propofol alone.
出处
《华南国防医学杂志》
CAS
2016年第1期35-39,共5页
Military Medical Journal of South China
关键词
依托咪酯
丙泊酚
混合液
无痛胃镜
并发症
Etomidate
Propofol
Sedation
Painless gastroscopy
Side effects
