小剂量丙泊酚联合舒芬太尼静脉麻醉在食管静脉曲张套扎术中的应用  

Low-dose of propofol combined with sufentanil for intravenous anesthesia during endoscopic variceal ligation

作　　者：杨清峰[1] 张旭[1] 江泳[1] 周磊[1] 张爽[1] 

机构地区：[1]安徽省蚌埠市第三人民医院消化内科,233000

出　　处：《蚌埠医学院学报》2013年第1期48-50,53,共4页Journal of Bengbu Medical College

摘　　要：目的:探讨小剂量丙泊酚联合舒芬太尼用于肝硬化患者内镜下食管静脉曲张套扎术(EVL)中清醒镇静的安全性和有效性。方法:将择期行EVL的患者根据清醒镇静药物组合及剂量不同,随机分成2组。Ⅰ组给予芬太尼1.5μg/kg,丙泊酚0.8～1.2 mg/kg,待患者睫毛反射消失,呼之不应时进行操作;Ⅱ组给予舒芬太尼0.12μg/kg,丙泊酚0.25～0.5 mg/kg,待患者OAA/S评分达3分时即进行操作。记录2组患者的心率、血压、呼吸、血氧饱和度,以及胃镜操作时间、恢复时间、患者和内镜医生满意度评分以及术中、术后不良反应。结果:Ⅱ组患者血压、呼吸和心率术前后均无明显变化(P>0.05),而Ⅰ组的低血压的发生率35.7%高于Ⅱ组(5.5%)(P<0.05);Ⅱ组的恢复时间明显短于Ⅰ组(P<0.05),2组的操作时间、患者和内镜医生满意度评分均无明显不同(P>0.05)。结论:小剂量丙泊酚联合舒芬太尼能安全有效地用于肝硬化患者EVL,患者具有较好的血流动力学稳定性和较少的呼吸抑制。Objective：To evaluate the efficacy and safety of combined therapy of low-dose of propofol and sufentanil for sedation in cirrhotic patients undergoing endoscopic variceal ligation （EVL）. Methods： Forty-six patients with cirrhosis scheduled for EVL were randomly divided into group Ⅰ and group Ⅱ according to the drug combination and dosage. Group I were injected with fentanyl 1.5 μg/ kg and propofol 0.8 - 1.2 mg/kg, and the endoscope was inserted after the patients had lost eyelash reflex and response ; group Ⅱ were given sufentanil 0. 12 μg/kg and propofol 0.25 - 0.5 mg/kg, and the endoscope was inserted when the OAA/S score reached 3. The heart rate, blood pressure, respiration and blood oxygen saturation were monitored;the duration of the endoscopy procedure, recovery time, adverse reaction,intraoperative bleeding, the patients＇ postoperative feeling and the doctors＇ satisfaction score were also recorded. Results： No significant changes were noted in the blood pressure and heart rate of the patients in group Ⅱ after induction （ P 〉 0.05 ）, whereas the patients in group Ⅰ had a higher incidence of hypotension （35.7% vs 5.5% ） （ P 〈 0.05 ）. The recovery time in group Ⅱ was shorter than that in group Ⅰ （ P 〈 0.05 ）. There were no significant differences in the duration of endoscopy procedure and the patients/doctors＇ satisfaction scores between the two groups （P 〉 0.05 ）. Conclusions：Low-dose of propofol combined with sufentanil can provide better hemodynamic stability and less respiratory depression than the general anesthesia in cirrhotic patients undergoing EVL.

关 键 词：食管静脉曲张 丙泊酚 舒芬太尼 静脉麻醉 套扎术 

分 类 号：R655.4[医药卫生—外科学]