胃镜检查术丙泊酚复合小剂量雷米芬太尼麻醉效果的临床观察  

Clinical Observation of Gastroscopy Propofol Combined with Small doses of Remifentanil Anesthesia

作　　者：刘凤勤[1] 

机构地区：[1]商丘市第一人民医院麻醉科,河南商丘476100

出　　处：《中国医药指南》2013年第10期13-14,共2页Guide of China Medicine

摘　　要：目的观察胃镜检查术患者丙泊酚小剂量雷米芬太尼(或芬太尼)麻醉的效果。方法拟行胃镜检查术患者100例,年龄18～65岁,体质量40～85kg,ASAI或III级,随机分为两组:丙泊酚-芬太尼-利多卡因组(PF组),丙泊酚-雷米芬太尼-利多卡因组(PRF组),每组50例。完善术前检查,入室取左侧卧位于检查台上,开放上肢静脉。接多功能监测仪器(迈瑞9000),常规监测血压、心率、呼吸、心电图及脉搏血氧饱和度。行鼻导管吸氧,嘱患者肘撐左手立于床上,静脉滴注雷米芬太尼0.5μg/kg,依次推注阿托品0.02mg/kg,利多卡因0.5～1mg/kg(按压注射部位前2.5cm处),随后注射丙泊酚1ml/6s,保留自主呼吸,待患者左手放下后停止注药,行胃镜检查术,术中酌情追加丙泊酚。记录麻醉诱导时间、胃镜检查时间、异丙酚用量、血流动力学改变及阿托品、麻黄素使用情况。术后苏醒时间、记录体动、呼吸暂停、低氧血症等术中知晓。术后头晕头痛等并发症情况。结果一般情况,胃镜检查时间,异丙酚用量等大多均无统计学意义(见表1示),麻醉诱导时间,术后苏醒时间,血流动学改变。术后头晕并发症发生率(P<0.05)(如表2、表3所示)。结论丙泊酚-复合小剂量雷米芬太尼,对胃镜检查患者循环与呼吸功能的影响较小、与丙泊芬复合芬太尼一样,用于胃镜检查术的麻醉是可行的。Objective To observe operation gastroscope inspection patients with phenol ＆shy; small dose tabor c remy fentanyl （or fentanyl） the effect of anesthesia. Methods To do gastroscope inspection technique in 100 cases, age 18-65 years old, 40-85 kg weight, ASA I or III, randomly divided into two groups： c poisson phenol-fentanyMidocaine group （PF group）, c poisson phenol-remy fentanyl-lidocaine group （PRF group）, each group of 50 cases. Improve preoperative examination, take home invasion lying on the left side is located in the examination table, open upper limbs vein. Meet multi-function monitoring instruments （mindray 9000）, regular monitoring the blood pressure and heart rate, respiration, electrocardiogram pulse and blood oxygen saturation. Do oxygen nasal catheter, instructing patients cubits in bed last left hand, intravenous drip remy fentanyl 0.5 gg/kg, which in turn push note atropine 0.02 mg/kg, lidocaine 0.5 1 mg/kg （2.5 cm before on the injection site in）, then injected c poisson phenol 1 ml / 6 s, keep spontaneous breathing, for patients after let go of the left hand to stop note medicine, line gastroscope inspection technique, the intraoperative discretionary additional c poisson phenol. Record time, gastroscope inspection narcotic induction time, propofol, dosage of hemodynamic changes and atropine, ephedrine use. The time, record body move came, and apnea, hypoxia in the operative known. Postoperative complications such as dizziness headache. Results Generally, gastroscope inspection time, propofol, such as the dosage of mostly both not significant （see table I shown）, narcotic induction time, the time came, the blood flow to learn to change. Postoperative complications dizzy （P〈0.05） （such as table II, table III shows）. Conclusion C-compound poisson phenol small doses remy fentanyl, to gastroscope inspection cycle and respiratory function in patients with less influence, and c at tabor ＆shy; composite fentanyl, used for gastroscope inspection technique the ane

关 键 词：胃镜检查术 小剂量雷米芬太尼 芬太尼 丙泊酚 

分 类 号：R614[医药卫生—麻醉学]