咪达唑仑与异丙酚在胃镜检查中的应用比较  

Midazolam versus propofol in gastroscopy

作　　者：姚凡保[1] 谢春松[1] 王小莹[1] 邓娟芬[1] 

机构地区：[1]广东医学院附属三水医院,佛山528100

出　　处：《国际医药卫生导报》2011年第17期2156-2158,共3页International Medicine and Health Guidance News

摘　　要：目的探讨咪达唑仑与异丙酚在胃镜检查中的安全性、有效性。方法选取在我科行无痛胃镜检查患者234例，其中A组123例，B组111例，检查前分别静脉注射咪达唑仑0．02～0．03mg·kg。与异丙酚1．2mg·kg^-1后行胃镜检查，并与常规组120例对照。结果A组的起效时间、苏醒时间为（2．5±1．6）mim、（10．8±2．1）mim；B组为（1．8±1．2）mim、（8．7±2．6）mim；检查中A组出现恶心、躁动、呛咳呼吸抑制的发生率为8．13％、25．20％、2．44％、0，B组为0、4．50％、O％、2．70％，比C组的85．00％、47．50％、24．16％、0明显减少（P〈0．05）；A、B组检查前、后SBP、DBP、HR、SPO2比较没有明显差异（P〉0．05），B组检查中与检查前比较SBP、DBP、HR下降较A组明显（P〈0．05），而SPO2则无明显变化（P〉0．05）。结论异丙酚无痛作用效果好，起效及苏醒时间短；眯达唑仑注药简单，无明显呼吸循环系统变化。两者在胃镜检查中安全、有效，不良反应较常规组明显减少，各单位可根据自身不同条件分别选用。Objective To investigate the safety and efficacy of midazolam and propofol in gastroscopy. Methods 234 patients scheduled for painless gastroscopy were divided into group A （ 123 patients ） and group B （ 111 patients ）. Group A received intravenous midazolam of 0.02 - 0.03mg· kg-1 and group B received propofol of 1.2mg ·kg-1 prior to endoscopy examination. 120 control subjects were group C. Results The onset time was （ 2.5± 1.6 ） mim in group A and （ 1.8 ± 1.2 ） mim in group B; and the awakening time was（ 10.2 ± 2.1 ） mim in group A and （ 8.7 ± 2.6 ）mim in group B. Rates of nausea, agitation, and dry cough were 8.13%, 25.20%, and 2.44% in group A and 0%, 4.50%, 0%, and 2.70% in group B, which were markedly lower than those in group C （ 85.00%, 47.50%, and 24.16%, respectively; P〈 0.05 ） SBP, DBP, HR, and SPO2 did not differ significantly in groups A and B after the procedure （ P 〉 0.05 ）. SBP, DBP, and HR, as compared with their baselines, decreased more significantly in group B than in group A （ P〈 0.05 ） during the procedure, while SPO2did not change significantly （ P 〉 0.05 ）. Conclusions Propofol has a better analgetic effect and shorter onset and awakening time; midazolam is simple in use and causes no significant changes in respiratory and circulatory systems. Either propofol or midazolam is safe and effective in gastroscopy and has fewer adverse reactions.

关 键 词：咪达唑仑 异丙酚 无痛胃镜 

分 类 号：R614[医药卫生—麻醉学]