咪唑地西泮复合芬太尼清醒镇静镇痛在结肠镜检查中的应用  

Application of Midazolam Combined with Propofol in Conscious Sedative and Analgesic Colonoscopy

作　　者：徐显林 谢伦雄 邝慕珠 张嘉 伍运生 龙泽民[2] 

机构地区：[1]广东省深圳市第七人民医院内镜科,518081 [2]深圳市蛇口人民医院消化内科

出　　处：《医学研究杂志》2007年第8期41-44,共4页Journal of Medical Research

基　　金：深盐科[2005]2号;2005W01

摘　　要：目的探讨咪唑地西泮复合芬太尼清醒镇静镇痛麻醉在结肠镜检查中应用的有效性及安全性。方法145例ASAⅠ～Ⅱ级患者随机分为两组:无痛结肠镜检查(A,n=75)组,传统结肠镜检查(B,n=70)组。A组静脉推注咪唑安定0.05mg/kg、芬太尼1μg/kg,开始进行结肠镜检查;B组施行传统结肠镜检查。结果A组注药开始检查后1minMAP、SpO2较注药前有明显下降(P<0.05),其余时段无显著性差异(P>0.05),呼吸抑制(SPO2<90%)发生率4%(3/75);B组检查开始后1、5、10和15min时MAP及HR较检查前明显上升(P<O.05)。A组92%(69/75)病人达Ramsay2～3级清醒镇静镇痛。A组镇静、镇痛、满意及遗忘程度和愿意再次检查率均明显优于B组(P<0.05)。结论咪唑地西泮复合芬太尼用于结肠镜检查中有良好的镇静镇痛效果,是安全有效的。Objective To investigate the effectiveness and safety of applying midzolam combined with propofol in conscious sedative and analgesic colonoscopy. Methods 145 cases of ASA Ⅰ - Ⅱ were included in this study. The patients were randomly divided into two Groups： Group A （painless colonoscopy） , Group B （conventional colonoscopy）. Group A was given midazolam 0.05mg/kg,fentanyl 1 μg/kg intravenously before operation. Group B was underwent conventional colonoscopy. Results The MAP,SpO2 at lmin after injection is lower significantly than that before injection in Group A （ P 〈 0.05 ）. There was no significant difference in terms of MAP SpO2 75 at 5, 10 and 15 mim of Group A （ P 〉 0.05 ）. The incidence of respiratory inhibition （ SPO2 〈 90% ） was 4% （ 3/75 ）. The MAP, HR at 1,5,10 after and 15min after colonoscopy is higher significontly than that before operation in Group B （P 〈 0.05 ）. There was 92% （69/75） at Ramsay2 - 3 grade of sedation and analgesia in Group A. The grade of sedation, analgesia, satisfaction of endoscope inspection, forget level and the incidence of willing for colonsocopy again in Group A were better than that in Group B （ P 〈 0. 05 ）. Conclusions Midazolam combined a with fentanyl in colonoscopy showed that It is a safe and efective method with high satisfaction.

关 键 词：结肠镜检查 清醒镇静 镇痛 咪唑地西泮 芬太尼 

分 类 号：R574.62[医药卫生—消化系统]