丙泊酚-芬太尼在小儿无痛胃肠镜麻醉中加入阿托品的效果研究  

Effect of Adding Atropine to Propofol-fentanyl Anesthesia for Pediatric Painless Gastroscopy

作　　者：文竹[1] 黄婧[2] 

机构地区：[1]绵阳市中心医院麻醉科,四川绵阳621000 [2]绵阳市中心医院内分泌科,四川绵阳621000

出　　处：《医学综述》2014年第9期1727-1728,F0003,共3页Medical Recapitulate

摘　　要：目的研究丙泊酚-芬太尼在小儿无痛胃肠镜麻醉中加入阿托品的效果。方法选择在绵阳市中心医院2007年3月至2012年3月接受无痛胃肠镜检查的患儿74例作为研究对象，按照随机数字表法分为观察组和对照组各37例，诱导期观察组给予阿托品0．03mg／kg皮下注射，5min后给予芬太尼1～2μg／kg、丙泊酚l～2mg／kg，分次静脉推注；对照组给予芬太尼1～2μg/kg、丙泊酚1～2mg／kg，分次静脉推注。观察麻醉前后两组生命体征、不良反应、生理应激情况。结果观察组插管后1、3、5min时，收缩压、舒张压、心率均显著低于对照组（P〈0．05），SpO2均高于对照组（P〈0．05），差异均有统计学意义。观察组患儿在检查过程中发生恶心呕吐3例（8．11％）、剧烈咳嗽3例（8．11％）、躁动不安2例（5．41％），均显著少于对照组[7例（18．92％）、8例（21．62％）、6例（16．22％）]（x2=6．782，7．283，8．921，P〈0．05）。检查后第3日，观察组患儿清醒时间（9．86±1．09）min、外周血血糖水平（4．31±0．49）mmol／L，显著低于对照组的（16．82±2．57）min、（5．67±0．62）mmoL／L；外周血胰岛素水平（13．98±1．62）mU／L显著高于对照组的（10，56±1．23）mU／L，差异有统计学意义（P〈0．05）。结论丙泊酚一芬太尼在小儿无痛胃肠镜麻醉中加入阿托品能稳定生命体征、减少不良反应，具有积极的临床价值。Objective To study the effect of adding atropine to propofol-fentanyl anesthesia for pediatric painless gastroenterological endoscope. Methods A total of 74 children receiving gastroscopy from Mianyang Central Hospital during Mar. 2007 and Mar. 2012 were included as research objects, and were diyided into observation group and control group according to the random number table method, 37 cases in each group, patients in the observation were given atropine 0.03 mg/kg, subcutaneous at the induction stage, and fentanyl 1-2 μg/kg and propol 1-2 mg/kg 5 min later, through intravenous injection at different times;and patients in the control group were given fentanyl 1-2 μg/kg and propol 1-2 mg/kg 5 min later,through intravenous injection at different times. The vital signs, adverse reactions, physiological stress situation of the two groups were observed. Results 1,3,5 min after intubation, systolic blood pressure, diastolic blood pressure, heart rate of the observation group were significantly lower than the control group （ P 〈 0.05 ）, SpO2 were significantly higher（ P 〈 0.05 ）. Nausea and vomiting occurred in three cases （8. 11 % ）, severe coughing in three cases （8.11% ） ,irritability in two cases （5.41% ） in the observation group, which were significantly less than the eontrol goop [ 7 cases （ 18.92% ）,8 eases （ 21.62% ）,6 eases （ 16. 22% ） ] （ X2 = 6. 782,7. 283,8. 921, P 〈 O. 05 ）. The awake time in the observation group （ 9.86± 1.09 ） rain, blood glucose level （ 4. 31 ± 0. 49） mmol/L 3 days after examination were significantly lower than those in the control group （ 16.82 ± 2.57 ） min, （5.67 ± 0. 62） mmol/L,blood insulin levels（ 13.98 ±1.62） mU/L was significantly higher than （ 10.56 ± 1.23 ） mU/L in the control group（ P 〈 0.05 ）. Conclusion Propofol-fentanyl combined with atropine in pediatric painless gastroscopy anesthesia can stabilize vital signs, reduce adverse reactions, which has positive clinical value,

关 键 词：无痛胃肠镜 丙泊酚 芬太尼 阿托品 

分 类 号：R614[医药卫生—麻醉学]