摘要
目的:观察不同靶浓度的瑞芬太尼联合咪达唑仑在老年患者无痛胃镜检查中的应用。方法:选择2019年1月至6月于我院内镜中心行无痛胃镜检查的120例老年患者,随机分为Ⅰ组、Ⅱ组、Ⅲ组,每组40例,分别静脉给予效应室靶控浓度为2、4、6 ng·ml^-1的瑞芬太尼及咪达唑仑20μg·kg-1。检查中,比较三组患者生命体征,胸壁强直、呼吸抑制、血流动力学波动等副作用发生情况,以及追加其他麻醉药物情况;同时记录患者警觉/镇静评分、耐受程度、术中呛咳、呃逆等情况以及术后恶心、呕吐的情况。结果:Ⅰ组患者存在明显镇静不足的情况。三组患者的心率、血压、氧饱和度在给药后,较给药前均有所下降,Ⅲ组患者氧饱和度下降更明显(P<0.05)。Ⅱ组和Ⅲ组呃逆反应明显低于Ⅰ组(P<0.05),而Ⅱ组和Ⅲ组相比较,差异无统计学意义(P>0.05)。三组术后恶心呕吐比较差异无统计学意义(P>0.05)。结论:瑞芬太尼4 ng·ml^-1靶控输注联合咪达唑仑在老年患者无痛胃镜检查中应用,镇静和镇痛效果确切、起效快、药物代谢迅速。
Objective:To observe the application of different target concentrations remifentanil combined with midazolam in elderly painless gastroscopy.Methods:A total of 120 elderly patients who underwent painless gastroscopy in the endoscopy center of our hospital from January to June 2019 were randomly divided into three groups(group Ⅰ,group Ⅱ and group Ⅲ,each with 40 patients).Remifentanil(target concentration of 2,4,6 ng·ml^-1,respectively)and 20μg·kg-1 midazolam were given intravenously to the effector chamber.During the examination,the vital signs of patients were compared,side effects included chest wall ankylosis,respiratory depression,hemodynamic fluctuation,and the addition of other anesthetic drugs were recorded.Also,the observer’s assessment of alertness/sedation(OAA/S)score,tolerance,intraoperative cough,hiccup and postoperative nausea and vomiting were recorded.Results:Patients in GroupⅠ had obvious sedative deficiency.Compared with before administration,heart rate,blood pressure and oxygen saturation of all patients were significantly decreased;and oxygen saturation of the patients in group Ⅲ decreased more obviously(P<0.05).Compared with hiccup reaction in group Ⅱ and group Ⅲ,the difference was not statistically significant(P>0.05),and the incidence rate of two groups was significantly lower than that of group Ⅰ(P<0.05).There was no significant difference in postoperative nausea and vomiting among the three groups(P>0.05).Conclusion:Remifentanil 4 ng·ml^-1 target-controlled infusion combined with midazolam was applied in the painless gastroscopy anesthesia of elderly patients,with definite sedative and analgesic effects,fast onset and rapid drug metabolism.
作者
李林锋
陈勇
雷雪
李强
Li Lin-feng;Chen Yong;Lei Xue;Li Qiang(Department of Anesthesiology,The Third People's Hospital of Chengdu,Chengdu 610031,Sichuan)
出处
《四川生理科学杂志》
2020年第1期30-34,共5页
Sichuan Journal of Physiological Sciences
关键词
瑞芬太尼
无痛胃镜
麻醉
老年
Remifentanil
Painless gastroscope
Anesthesia
Agedness
