靶控输注依托咪酯复合瑞芬太尼配伍咪达唑仑或丙泊酚用于肠镜检查的观察  

Efficacy of target controlled infusion of etomidate compound remifentanil with midazolam or propofol in colonoscopy

作　　者：蔡小丽[1] 秦新刚[1] 李帆[1] 

机构地区：[1]新疆医科大学第五附属医院麻醉科,乌鲁木齐市830011

出　　处：《中国临床研究》2013年第7期647-649,共3页Chinese Journal of Clinical Research

摘　　要：目的观察靶控输注依托咪酯复合瑞芬太尼加用咪达唑仑或丙泊酚用于肠镜检查中的麻醉效果。方法择期ASAⅠ～Ⅱ级行电子肠镜检查患者80例,随机分为A组(瑞芬太尼+依托咪酯+咪达唑仑)40例、B组(瑞芬太尼+依托咪酯+丙泊酚)40例。记录麻醉前(T0)、达到目标效应室浓度(T1)、靶控输注2min(T2)、停药时(T3)的收缩压(SBP)、舒张压(DBP)、心率(HR)、呼吸频率(RR)、血氧饱和度(SpO2);抽取T1、T3时点动脉血,检测氧分压(PaO2)、二氧化碳分压(PaCO2);记录麻醉诱导时间、停药后清醒时间、靶控输注依托咪酯总量、阿托品、麻黄素用量;观察各组肌颤、体动、恶心、呕吐、呼吸暂停、清醒后头晕等不良反应发生率。结果两组SBP、DBP、HR、RR、SpO2及PaCO2不同时点比较及组间比较差异无统计学意义(P均>0.05);两组PaO2T1时与T3时组内比较,差异有统计学意义(P均<0.05);B组清醒时间较A组短(P<0.05);肌颤、头晕的发生率较A组低(P均<0.05),体动、恶心、呕吐的发生率两组比较差异无统计学意义(P均>0.05)。结论靶控输注依托咪酯,配伍小剂量丙泊酚,复合瑞芬太尼,是更适于肠镜检查的麻醉方式。Objective To evaluate the efficacy of target controlled infusion （TCI） of etomidate compound remifentanil with midazolam or propofol in colonoscopy. Methods Eighty patients of ASA Ⅰ-Ⅱ underwent the examine of colonoscopy were randomly divided into two groups,group A （remifentanil＋etomidate ＋ midazolam） and group B （remifentanil ＋ etomidate＋propofol） ,with 40 cases each. The systolic blood pressure （SBP） ,diastolic blood pressure （DBP） ,heart rate （HR） ,respiratory frequency （RR） and blood oxygen saturation （SpO2） were recorded at the beginning of anesthesia （T0） ,the time reached the targeting effect compartment concentration （T1） ,2 mins after TCI （T2） ,and infusion finished time （T3） . PaCO2 ,PaO2 were detected at T1 and T3 . The time of anesthesia inducted and patients woke up after the infusion finished,the total dose of etomidate by TCI,atropine and ephedrine dose used were recorded. The incidence of the side effects which including twitch,body movement,nausea,vomiting,apnea were recorded in both groups. Results The comparison of SBP,DBP,HR,RR, SpO2 at different time and in different groups showed no significant difference （all P0. 05） ; It had statistical differences of PaO2 between T1 and T3 in two groups（all P0. 05） . PaCO2 showed no difference between groups and between different time in one group（all P0. 05） . Compared to group A,patients in group B had a shorter wake up time and lower incidence rates of side effects （all P0. 05） . Conclusion Remifentanil compound TCI of etomidate with propofol is better than with midazolam in the colonoscopy.

关 键 词：靶控输注 依托咪酯 咪达唑仑 丙泊酚 肠镜 

分 类 号：R614.2[医药卫生—麻醉学]