镇静无痛苦胃镜检查中两种联合用药的效果评价及安全性研究  

Evaluation of the effect and security on fentanyl-propofol and midazolam-propofol in gastroscopy

作　　者：罗咏萍[1] 梅浙川[1] 

机构地区：[1]重庆医科大学附属第二医院消化内科,400010

出　　处：《重庆医学》2004年第9期1344-1346,共3页Chongqing medicine

摘　　要：目的　探讨联合应用芬太尼 异丙酚与咪唑安定 异丙酚在胃镜检查中的镇静镇痛效果和安全性。方法　将胃镜检查者随机分为芬太尼 异丙酚组 (Ⅰ组 ) ,咪唑安定 异丙酚组 (Ⅱ组 )和对照组 (常规胃镜组 ,Ⅲ组 )。观察记录各组受检者术中的反应、胃镜操作时间、麻醉药物作用时间 ,检查前中后BP、HR、SPO2 和SDNN(正常R R间期标准差 ) ,及术后问卷调查。结果　Ⅰ、Ⅱ组术中不适反应少、胃镜操作时间短、10 0 %舒适无痛苦 (P <0 .0 5 )。Ⅲ组术中BP、HR显著增高 ,SDNN显著下降 (P <0 .0 1) ,而Ⅰ、Ⅱ组术中BP、HR及SDNN均一过性轻度下降 (P <0 .0 1)。与Ⅱ组比较Ⅰ组药物起效更快、苏醒及清醒时间更短、术中不适反应更少 (P <0 .0 1)。结论　联合应用芬太尼 异丙酚及咪唑安定 异丙酚在镇静无痛苦胃镜检查中是舒适安全的 ,芬太尼 异丙酚联用起效更快、恢复时间更短、不适反应更少。Objective To evaluate the sedative and analgesic effect and the security of fentanyl-propofol and midazolam-propofol in gastroscopy.Methods The patients undergoing gastroscopy were randomly divided into three groups:fentanyl-propofol group (group I),midazolam-propofol group (group Ⅱ) and control group(group Ⅲ).The reaction of patients,the effect of sedation and analgesia,the variation of Bp,HR,SPO 2 and SDNN during examination were observed.Questionnaires were proceeded after gastroscopy.Results Patients in groupⅠand Ⅱ felt much less discomfortable than group Ⅲ(P<0.05),and also the time of gastroscopy in groupⅠand Ⅱ is shorter (P<0.05).The BP and HR during gastroscopy in group Ⅲ increased significantly and the SDNN decreased remarkablely compared with those of patients before the examination,but in groupⅠand Ⅱall the BP,HR and SDNN during gastroscopy decreased slightly.The time of patients coming into unconsciousness and the time of patients regaining consciousness in groupⅠwere shorter than groupⅡ(P<0.01).Conclusion Fentanyl-propofol and midazolam-propofol could make gastroscopy more effective,more comfortable and safer.Fentanyl-propofol was more suitable for sedative and analgesic gastroscopy than midazolam-propofol.

关 键 词：胃镜检查 静脉麻醉 芬太尼—异丙酚 咪唑安定—异丙酚 

分 类 号：R573[医药卫生—消化系统]