瑞芬太尼应用在无痛胃镜中的并发症观察  

Complications of Intravenous Remifentanil and Propofol for Gastroscopy

作　　者：徐志勇[1] 王晓[1] 李杰 思永玉[1] 吴俊超[3] 刘进[1] 

机构地区：[1]四川大学华西医院麻醉科,四川成都610041 [2]人福药业有限责任公司,湖北宜昌443000 [3]四川大学华西医院内镜中心,四川成都610041

出　　处：《华西医学》2006年第1期37-38,共2页West China Medical Journal

摘　　要：目的：探讨瑞芬太尼和异丙酚联合应用于无痛胃镜的可能并发症。方法：300例成年ASAⅠ-Ⅱ患者随机分为三组，芬太尼和异丙酚组（99例）、瑞芬太尼和异丙酚组（100例）以及5％GS和瑞芬太尼-异丙酚合剂组（101例）。每ml瑞芬太尼-异丙酚合剂含有瑞芬太尼1．5μg和异丙酚5mg。双盲法静脉缓注5μg／ml芬太尼或5μg/ml瑞芬太尼或5％GS。1min后，静脉缓注异丙酚或瑞芬太尼-异丙酚合剂。异丙酚或瑞芬太尼-异丙酚合剂的角量根据麻醉深度调节，以满足检查需要和不导致低氧血症（SPO2〈90％）为准。结果：瑞芬太尼组较芬太尼组：一般体动发生率较低（P〈0．05），但是心动过缓和低血压发生率较高（P〈0．05）。虽然呼吸暂停发生率较高（P〈0．05），但是低氧血症发生率无统计学意义（P〉0．05）。合剂组较芬太尼组：体动发生率较低（P〈0．05），但是低氧血症、心动过缓、低血压以及异丙酚注射痛发生率都较高（P〈0．05）。结论：瑞芬太尼和异丙酚联合应用于无痛胃镜时，体动发生少，但是低血压和心动过缓较多见，特别要重视瑞芬太尼-异丙酚合剂可能引起的低氧血症。Objective： To evaluate the complications of intravenous remifentanil and pmpofol for gastroscopy.Metheds： Prospective, randomized and double-blinded clinical trial were used.300 ASA Ⅰ - Ⅱ adult patients undergoing gastroscopy were randomly assigned to one of the three modes of administration.Anesthetics were diluted with 5% dextrose.1ml remifentanil- pmpofol mixture contains remifentanil 1.5μg and pmpofol 5.0μg.Two minutes before gastroscopy： fentanyl group received 05μg/kg fentanyl,followed by bolus injection of 5 mg/ml propofol;remifentanil group received 0.5μg/kg remifentanil,fllowed by propofol;and Mixture group received 0.1ml/kg of 5%dextrose,followed by remifentanil-propofol mixture,The doses of propofol or remifentanil-propofol mixture was adapt to clinical needs,Results;The incidence of slight body movement in remifentanil was lower than that in fentanil group （P〈0.05）,The body movements in mixture group reported the least （P〈0.05） among the three groups .However,much higher incidence of bradycardia or hypotension in remifentail and mixture groups was found than that in fentanyl group （both P〈0.05）,Moreover,the incidence of hypoxemia was the highest （P〈0.05） among three groups No significant difference （P〉0.05） was observed between remifentanil group and fentanyl group in terms of the incidence of hypoxemia .Conclusion：Intravenous remifentanil and propofol for gastroscopy provides less body movements compared with intravenous fentanyl and propofol ,However,cautions should be taken by the frequent occurrence of hypoxemia with intravenous remifentail-propofol mixture.

关 键 词：瑞芬太尼 异丙酚 胃镜 并发症 低氧血症 

分 类 号：R573[医药卫生—消化系统]