丙泊酚、瑞芬太尼、麻黄碱在胃镜检查中的应用  

The applying of propofol, remifintanil, ephedrine in gastroscopy

作　　者：李安学[1] 董惠翔[1] 刘玉春[1] 杨兵[1] 刘作坤[1] 蔡云亮[1] 

机构地区：[1]广东省深圳市龙岗区人民医院麻醉科,518172

出　　处：《中国临床实用医学》2008年第8期24-26,共3页China Clinical Practical Medicine

摘　　要：目的观察丙泊酚、瑞芬太尼、麻黄碱配合应用于胃镜检查时对循环、呼吸功能及麻醉效应的影响。方法患者120例，随机分为3组，A组单用丙泊酚；B组合用丙泊酚与瑞芬太尼；C组合用丙泊酚、瑞芬太尼及麻黄碱。观察患者药物用量、苏醒时睁眼、对答和自行离去时间、循环呼吸功能及不良反应。结果B、C组丙泊酚用量比A组明显减少（P〈0．05），呼之睁眼及自如对答时间比A组缩短（P〈0．05），而C组患者自行离开时间要短于A、B两组（P〈0．05）；A、B两组患者用药后及呼之睁眼时MAP均较检查前明显降低、HR减慢（P〈0．05），而C组患者检查前、用药后及呼之睁眼时MAP和HR均没有显著性差异（P〉0．05）；3组患者用药后及呼之睁眼时RR均减慢，SpO2降低（P〈0．05）；B、C组的注射部位疼痛及检查时肢体活动发生率比A组显著降低（P〈0．05）。结论瑞芬太尼伍用于丙泊酚可减少丙泊酚用量，降低注射部位疼痛及检查时肢体活动发生率，但并不减轻对循环呼吸的抑制作用；丙泊酚、瑞芬太尼、麻黄碱伍用则既能减少丙泊酚用量，循环功能亦较稳定，但不能减轻对呼吸的抑制作用。Objective To observe the effect of propofol, remifintanil, ephedrine to circulation-breath function and the effect being anaesthetized in gastroseopy. Methods 120 patients were divided randomly into group A （ propofol only）, B （ propofol, and, remifintanil ） and C （ propofol, remifintanil, and ephedrine ）. Medicine dosages, awake time, circulation-breath function and side effect were recorded. Results Propofol dosages were lower in group B and C than group A （ P 〈 0. 05 ） , bur awake time was shorter than group A （ P 〈 0. 05 ）. Leavingself time in group C was shorter than group A and B （ P 〈 0. 05 ）. Average arterial pressure and heart rate after anesthesia fallen significantly in group A and B（P 〈0. 05） ,and no changing in group C（P 〉0. 05）. Breath rate and pulse oxygen saturation fallen significantly after anesthesia in three groups（ P 〈 0. 05 ）. The rate of inject location pain and limb moving were lower in group B and C than group A （ P 〈 0. 05 ）. Conclusion Remifentanil and propofol combination can reduce the propofol dosages ,the incidence of injection site pain and physical activities, but not ease off circulation-breath inhibitory action. However, that propofol, remifentanil, combined with ephedrine will reduce the amount of propofol ,circulatory function more stable ,but it cannot mitigate their inhibitory effect on respiration.

关 键 词：异丙酚 瑞芬太尼 麻黄碱 胃镜检查 

分 类 号：R614[医药卫生—麻醉学] R573[医药卫生—外科学]