戊乙奎醚与依托咪酯用于无痛胃镜诊疗的对照研究  

A contrast study of penehyclidine hydrochloride and etomidate used in sedative gastroscope

作　　者：程翔[1] 支晓雁[1] 文生豪[1] 田国刚[1] 

机构地区：[1]中南大学湘雅医学院附属海口医院,570208

出　　处：《山西医药杂志（上半月）》2013年第6期613-615,共3页Shanxi Medical Journal

摘　　要：目的观察戊乙奎醚与依托咪酯在无痛胃镜诊疗中应用的利弊。方法选择美国麻醉师协会(ASA)Ⅰ～Ⅱ级,于我院行无痛胃镜检查或治疗的患者100例,随机分为2组,A组(常规组)48例,诱导用药:阿扎司琼0.2mg/kg、芬太尼1μg/kg、丙泊酚2mg/kg,序贯静脉注射;维持用药:间断给予丙泊酚;B组(依托咪酯组)52例,诱导用药:戊乙奎醚0.01mg/kg、阿扎司琼0.2mg/kg、芬太尼1μg/kg、依托咪酯0.15mg/kg、丙泊酚1mg/kg,序贯静脉注射;维持用药:间断给予丙泊酚、依托咪酯。比较2组的诱导时间、血流动力学指标(意识消失时、胃镜插入后即刻、胃镜拔出后即刻的血压、心率)、呼吸抑制的发生率、苏醒时间及术后并发症的发生率。结果 2组诱导时间差异无统计学意义,A组呼吸抑制发生率高于B组(P<0.05),苏醒时间明显短于B组(P<0.05),B组术后并发症的发生率明显高于A组(P<0.05),且复视多见于青年人,谵妄多见于老年人。A组麻醉后各时点的血压、心率明显低于麻醉前及同时点B组水平(P<0.05),A组意识消失时的血压低于胃镜拔除后即刻(P<0.05);B组麻醉后各时点的血压、心率稍降低,但与麻醉前相比差异无统计学意义(P>0.05)。结论在无痛胃镜诊疗中推荐应用依托咪酯,尽量避免应用戊乙奎醚。Objective To investigate the advantage and disadvantage of penehyclidine hydrochloride and eto- midate used in sedative gastroscope. Methods One hundred cases who were ASA Ⅰ～Ⅱ , examined or cured by sedative gastroscope, were chosen and randomly divided into two groups. Group A （regular anesthesia group） ： 48 cases, anesthesia induction： azasetron 0.2 mg/kg , fentanyl 1 μg/kg, propofol 2 mg/kg, injected sequentially by vein. Group B （etomidate group） .. 52 cases, anesthesia induction., penehyclidine hydrochloride 0.01 mg/kg , azasetron 0.2 mg/kg, fentanyl 1μg/kg, etomidate 0.15 mg/kg, propofol 1 mg/kg, injected sequentially by vein. Induction time, haemodynamics（the time point of unconsciousness, putting the endoscopy into esophagus, pulling the endoscopy out of patient）, the rate of breath-holding, recovery time and the rate of postoperative complications were compared. Results There was no difference in the induction time （P〈0.05）, the rate of breath-holding of A group was higher than that of B group （P〈0.05）, the recovery time was shorter than that of B group （P〈 0.05）, the postoperative complications of B group were more than that of A group （P〈0.05）, and diplopia was seen more common in young people, delirium was seen more at old people. The blood pressure and heart rate after the anesthesia of A group were significantly lower than the level before anesthesia and the same time point of group B （P〈0.05）, the blood pressure of unconsciousness was lower than the level of pulling the endoscopy out patient in A group （P〈0.05）. The blood pressure and heart rate after anesthesia were slightly lower than the level before anesthesia, but there is no statistical difference in B group （P〈0. 05）. Conclusion It is suggested etomidate be used in sedative gastroscop. And application of penehyclidine hydrochloride should be avoided.

关 键 词：依托咪酯 胃镜 戊乙奎醚 

分 类 号：R614[医药卫生—麻醉学]