SI监测不同剂量芬太尼复合丙泊酚对胃镜检查效果  

THE EFFECT OF DIFFERENT DOSAGE OF FENTANYL COMBINED WITH PROPOFOL USED IN GASTROSCOPY

作　　者：谢平[1] 董少梅[1] 艾登斌[1] 陈富强[1] 姜敏[1] 帅训军[1] 

机构地区：[1]青岛市市立医院麻醉手术科,山东青岛266071

出　　处：《齐鲁医学杂志》2010年第6期522-523,共2页Medical Journal of Qilu

摘　　要：目的通过使用SNAP指数(SI)监测麻醉深度,以寻求合适剂量的芬太尼复合丙泊酚用于胃镜检查。方法选择60例ASAⅠ～Ⅱ级自愿接受睡眠胃镜检查的病人,随机分为A、B、C共3组,每组20例,应用SNAPTM监测仪监测SI,丙泊酚首次剂量均采用1.5mg/kg,3组病人均于丙泊酚给药前1min分别注射枸橼酸芬太尼0.5、0.7、1.0μg/kg。3组均待病人睫毛反射消失后开始置胃镜,检查中根据SI调整丙泊酚用量,胃镜抵达十二指肠降部停止用药。结果对比0.5μg/kg芬太尼复合丙泊酚用于胃镜检查,增加剂量至0.7及1.0μg/kg并不能进一步减轻咽喉反射、减少体动、加速苏醒及定向力恢复,而应用较大剂量(1.0μg/kg)芬太尼可明显增加呼吸抑制发生率(χ2=17.65,P<0.01)。结论推荐使用小剂量芬太尼(0.5μg/kg)复合丙泊酚用于胃镜检查。Objective To seek an optimal dosage of Fentanyl combined with Propofol for gastroscopy by using SNAP index （SI） to monitor the depth of anesthesia. Methods Sixty ASA Ⅰ--Ⅱ patients who voluntarily accepted the sleep gastroscopy were evenly randomized to groups A, B and C. The SNAPTM was used to monitor the SI. The first dose of Propofol was 1.5 mg/kg. One minute before the administration of Propofol, the patients in each group were injected Fentanyl Citrate, 0.5, 0.7 and 1.0 μg/kg, respectively. The examination started when patients＇ lash reflex disappeared. The dosage of Propofol was adjusted according to SI, and the anesthetic discontinued when the gastroscope reached descending part of duodenum. Results Compared with 0.5 μg/kg Fentanyl plus Propofol in gastroscopy, and increase of the dose of Fentanyl to 0.7 μg/kg and 1.0μg/kg could not further reduce throat reflex, body movement or accelerate analepsia and orientation recovery. A higher dosage （1.0 μg/kg） of Fentanyl obviously increased the incidence of respiratory depression （X^2=17.65,P〈0.01）. Conclusion For gastroscopy, a lowdose Fentanyl （0.5 μg/kg） and Propofol is recommended.

关 键 词：SI 监测 麻醉药 联用 芬太尼 丙泊酚 胃镜检查 

分 类 号：R443[医药卫生—诊断学]