帕瑞昔布钠与舒芬太尼对无痛胃镜麻醉安全性及满意度影响的研究  

Research on the Anesthetic Saftey of Parecoxib and Sufentanil for Patients Undergoing Gastroscopy and Their Effect on Patients' Satisfaction

作　　者：张翔[1] 刘斌[1] 

机构地区：[1]四川大学华西医院麻醉科,成都610041

出　　处：《华西医学》2013年第6期859-863,共5页West China Medical Journal

摘　　要：目的观察帕瑞昔布钠与舒芬太尼用于无痛胃镜麻醉的安全性和有效性及对患者满意度的影响,为提高临床无痛胃镜麻醉的安全性和舒适性提供依据。方法采取前瞻性随机双盲对照方法,纳入2011年8月-12月拟行无痛胃镜检查的患者120例,随机分为3组。患者于胃镜检查开始前口服利多卡因胶浆,静脉注射舒芬太尼、帕瑞昔布钠或生理盐水10 mL。检查时静脉注射异丙酚。记录患者检查过程中生命体征、异丙酚使用量、诱导时间、检查时间、苏醒时间、医师以及患者满意度、舒适度等数据。结果舒芬太尼组检查中各时间点平均动脉压明显低于帕瑞昔布组(P=0.029),血管活性药物用量明显高于帕瑞昔布组(P=0.036)。医师以及患者满意度舒芬太尼组和帕瑞昔布组相当,且均高于对照组(P<0.05)。除呛咳外,帕瑞昔布组其他不良反应的发生率明显低于舒芬太尼组(P<0.05)。结论实施无痛胃镜检查前15 min静脉注射帕瑞昔布钠0.6 mg/kg或舒芬太尼0.10μg/kg均可以获得满意的麻醉效果,麻醉医师和患者及家属的满意度明显增高,且帕瑞昔布对呼吸和循环的影响更小,安全性更高。Objective To investigate the safety and clinical effect of parecoxib or sufentanil for painless gastroscopy and their effect on patients＇ satisfaction.Methods In this prospective double-blind placebo-controlled trial,120 ASA class I-II patients who would undergo painless gastroscopy between Auguest and December 2011 were randomly assigned to three groups.After taking lidocaine gel,patients received equal volumes of intravenous saline（group C）,or sufentanil 0.1μg/kg（group S）,or parecoxib 0.6 mg/kg（group P） 15 min before the examination.The induction was administered with propofol.The vital signs during examination,the dose of propofol,waking time,visual analogue scales（VAS） for satisfaction and adverse effects were recorded and analyzed with SPSS 18.0.Results The MAP of Group S during examination was significantly lower than Group P（P=0.029）.The VAS scores from doctors and patients in Group S and Group P were better than those in Group C（P〈0.05）.The adverse effects（such as respiratory depression,upper respiratory tract obstruction and hypotension） in Group P were significant fewer than those in Group S（P〈0.05） except cough during the examination.Conclusions Using sufentanil 0.1 ug/kg or parecoxib 0.6 mg/kg about 15 minutes before the examination can provide satisfactory anesthesia effect for painless gastroscopy and improve the satisfaction of doctors and patients.Compared with sufentanil,parecoxib may have less impact on respiratory and circulation system,and the safety is better.

关 键 词：无痛胃镜 帕瑞昔布钠 舒芬太尼 满意度 

分 类 号：R614[医药卫生—麻醉学]