无痛技术在高龄高危患者胃镜检查中的应用  

Painless gastroscopy for high-risk elderly

作　　者：杨康[1] 魏揠琴[1] 罗玉明[1] 

机构地区：[1]四川省医学科学院.四川省人民医院城东病区麻醉科,四川成都610101

出　　处：《四川医学》2012年第12期2119-2121,共3页Sichuan Medical Journal

摘　　要：目的探讨无痛技术在高龄高危患者胃镜检查中的安全性和可行性。方法选择年龄在70岁以上合并心、肺、脑、肾等基础疾病的患者320例,随机分为两组,A组和B组,每组160例:A组:芬太尼+丙泊酚组:静脉缓慢推注芬太尼0.5μg/kg,注入时间15s,丙泊酚1.2～1.5mg/kg,注入时间30s;B组:曲马多+丙泊酚组,静脉缓慢推注曲马多0.25mg/kg,丙泊酚1.2～1.5mg/kg,注入时间与A组相同。待两组患者入睡、全身松弛、呼吸平稳进入麻醉状态后开始胃镜检查。观察并记录两组患者检查前(T0)、检查中(T1)、检查后(T2)、苏醒后10min(T3)的心率(HR)、无创血压(NIBP)、血氧饱和度(SpO2)的变化,以及操作时间、苏醒时间、追加药物次数。结果两组患者检查中(T1)的HR、NIBP、SpO2较检查前(T0)均有一定程度的下降(P<0.05),但波动均在正常范围内。A组有6例、B组有3例SpO2下降至95%以下,经托下颌处理后很快恢复正常。两组组间比较差异统计学意义P>0.05。两组均在一次性给药后完成检查,检查时间和苏醒时间无差异。结论芬太尼、曲马多联合小剂量丙泊酚的无痛技术用于高龄高危患者的胃镜检查是安全有效、可行的。Objective To evaluate feasibility and security of this investigation in High-risk elderly. Methods 320 pa- tients,70 years old and more with diseases of eardio, brain, pulmonary, kidney and etc. were enrolled and divided randomly into two groops, each group included 160 patients： group a： fentanyl plus propofol （intravenous injection fentanyl 0. 5μg/kg slowly within 15 seconds and propofol 1.2 ～ 1.5mg/kg within 30 seconds）, groop b： tramadgl plus propofol （intravenous injection tra- madol 0. 25mg/kg slowly and propofol 1.2 ～ 1.5mg/kg, within the same injoelioo time os group a ） . Two groups underwent gas- troscopy after the patients into anesthesia who were sleepping, relaxed, breathing smoothly. HR, N1BP, SpO2 were observed and recorded at each time：before the test （TO ） while inspection （Ti） , after inspection （T2 ） , 10 minutes after regained con- seiousness （ T3 ） as well as operating time , recovery time and the number of additional drug. Results Comparing with baseline （TO ）, the HR, NIBP, SPO2 while inspection （T l）were decreased in some extent （ P 〈0. 05 ） ,bm the fluctuations were within normal range. The SpO2-six eases in group A , three eases in group B were dropped below 95%, but returning normal soon af- ter treatment. There were no significant differences between two groups in HR, N1BP, SpO 2 （ P 〉 0.05 ）, and so does the inspec- tion time and wake time. Both groups complete the examination after one-time administration. Conclusion Painless gastroscopy with Fentanyl , tramadol plus small dose of propofol in high-rlsk elderly was safe, effective and feasible

关 键 词：无痛胃镜 高龄高危患者 

分 类 号：R614[医药卫生—麻醉学]