异丙酚分别联合芬太尼和咪达唑仑应用于无痛胃镜的临床效果评价  

The clinic effect evaluation of propofol combined with fentanil or midazolam for painless gastroscopy

作　　者：赵宏[1] 孙艺丹[1] 

机构地区：[1]新疆医科大学第一附属医院麻醉科,新疆乌鲁木齐830054

出　　处：《新疆医科大学学报》2005年第7期638-639,642,共3页Journal of Xinjiang Medical University

摘　　要：目的:探讨异丙酚分别联合小剂量芬太尼和咪达唑仑应用于无痛胃镜检查的可行性及不良反应。方法:40例ASAI～Ⅱ级的为胃镜检查患者.随机分为异丙酚-芬太尼组(A组)及异丙酚-咪达唑仑(B组)组,每组20例。A组静脉注射芬太尼1μg/kg,B组静脉注射咪达唑仑0.02mg/kg.3min后静脉给予异丙酚1～1.5mg/kg,Ramsay镇静/镇痛等级评分Ⅳ级即可插镜。如有呛咳或体动.酌情追加异丙酚10～30mg。记录检查前、插镜时、检查结束时HR、SBP、DBP、MAP、SpO2以及用药量、苏醒时间和不良反应。结果:与A组比较,B组插镜时HR、SBP和MAP均升高(P<0.05)。B组用药总量明显大于A组(P<0.01)。B组不良反应发生率也高于A组(P<0.05)。结论:异丙酚联合小剂量芬太尼麻醉效果好,不良反应少,苏醒迅速而质量高,更适用于胃镜检查.值得临床推广应用。Objective: To investigate the feasibility and side effects of propofol combined with small dose of fentanil or midazolam for painless gastroscopy. Methods: Forty ASAI-Ⅱ patients scheduled for gastroscopy were randomly divided into 2 groups: propofol- fentanil group (group A, n =20) and propofol-midazolam group (group B, n =20). Patients were given fentanil 1μg/kg intravenously in group A and midazolam 0. 02 mg/kg in group B. Three minutes later injected propofol 1-1. 5 mg/kg in both groups. If the patients reached class Ⅳ of Ramsay score, inserted the gastroscope. More propofol was given, 10mg-30 mg at a time, if there were the signs of light anesthesia such as cough and movement. HR, SBP, DBP, MAP, SpO2 were continuously monitored and recorded before, during and after gastroscopy. At the same time noted the total drug consumption, the recovery time and the side effects. Results: In group B HR, SBP and MAP were significantly higher than that in group A (P <0. 05) while inserting the gastroscope. The total drug doses was significantly larger than that in group A (P <0. 01). The incidence of side effects in group B was also higher (P <0. 05). Conclusion: Propofol combined with small dose of fentanil showed higher anesthesia quality, less side effects, and more rapid and smooth recovery than propofol combined with midazolam. Propofol combined with small dose of fentanil is a better method for painless gastroscopy and worth popularizing and applying clinically.

关 键 词：异丙酚 芬太尼 咪达唑仑 无痛胃镜 

分 类 号：R971.2[医药卫生—药品] R573[医药卫生—药学]