不同剂量的丙泊酚和咪唑安定复合舒芬太尼在门诊老年患者经食道超声心动图检查中的应用  

Application of Different Doses of Propofol and Midazolam Combining with Sufentanil in Elderly Outpatients Undergoing Transesophogeal Echocardiography

作　　者：范丹[1] 黄建新[1] 徐广民[1] 李鹏[1] 梁涛[1] 

机构地区：[1]四川省人民医院麻醉科,四川成都610072

出　　处：《四川医学》2016年第1期54-57,共4页Sichuan Medical Journal

摘　　要：目的比较不同剂量的丙泊酚与咪唑安定在门诊老年患者经食道超声心动图检查中的麻醉效果及不良反应。方法选择36例在门诊需行经食道超声心动图（TEE）测量评估左心耳形态的老年合并心房颤动（房颤）患者,随机分为3组,每组12例,1组（G1）丙泊酚1.5mg/kg复合舒芬太尼5μg;2组（G2）咪唑安定0.02mg/kg联合丙泊酚1.5mg/kg复合舒芬太尼5μg;3组（G3）咪唑安定0.02mg/kg联合丙泊酚1.0mg/kg复合舒芬太尼5μg。记录各组麻醉前（T_0）、入睡后（T_1）、术中10min（T_2）、术中20min（T_3）、检查结束（T_4）时患者的平均动脉压（MAP）、心率（HR）、脉搏氧饱和度（SpO2）的变化及Ramsay镇静评分（RSS）,记录并比较各组手术时间、食道探头置入呛咳、术中体动、苏醒时间、定向力恢复时间及术后的不良反应。结果与T0比较,3组患者MAP、HR在T_1~T_2时点均下降,差异有统计学意义（P〈0.05）,与G3组比较,G1、G2组下降更明显,差异有统计学意义（P〈0.05）;T_1~T_3时G2组RSS评分多例达到5分,G1组多为2~3分,G3组以3~4分居多;G1组食道探头置入呛咳、术中体动发生率高于G2、G3组,差异有统计学意义（P〈0.05）。三组患者苏醒时间、定向力恢复时间G2组慢于G1、G3组,差异有统计学意义（P〈0.05）,所有患者均未见术后不良反应。结论小剂量咪唑安定联合丙泊酚复合舒芬太尼可以安全有效地用于门诊老年房颤患者的TEE检查。Objective To evaluate the anesthesia effects and adverse effects of different doses of propofol and midazolam combining with sufentanil in TEE in elderly outpatients. Methods Thirty-six elderly outpatients with atrial fibrillation undergoing TEE were selected and divided randomly into three groups（ 12 in each group）. In group 1 （G1）, patients accepted propofolat a dose of 1.5mg/kg combined with sufentanil at dose of 51μg intravenously. In group 2 （G2）, patients accepted midazolam at dose of 0. 02mg/kg with propofol at dose of 1.5mg/kg and sufentanil at dose of 5lμg intravenously. In group 3 （G3）, patients accepted mid- azolam at dose of 0. 02mg/kg with propofol at dose of 1.0mg/kg and sufentanil at dose of 5μg intravenously. Mean arterial blood pressure, Heart rate, oxygen saturation and the Ramsay sedation scores（RSS） were recorded during before drug administration（T0 ）, sedation（T1）, 10min after operation（ T2 ） ,20min after operation （T3 ）, and end of operation （T4）. The following parameters were also recorded and compared, including operation time, bucking response with transesophageal echocardiography probe, body move- ment in operation, conscious recovery time, orientation recovery time and adverse effects after operation. Results Compared with To, MAP and HR decreased in all the three groups after administration of sedation at T 1 and T2 （ P 〈 0.05 ）, compared with G3, MAP and HR were decreased obviously in G1 and G2（P 〈 0. 05）. At T land T3, most patients obtained scores of 2-3 within RSS scale in G1. In G2, more cases obtained scores up to 5. In G3, most patients obtained scores of 3-4. In comparison with G2 and G3, the inci- dence rates of buking response and body involuntary movement in operation were significantly higher in G1. Conscious and orientation recovery time were obviously increased in G2 compared with those of G1 and G3. No adverse effect were observed after operation. Conclusion The application of small-dosage propofol with midazolam com

关 键 词：丙泊酚 咪唑安定 经食道超声心动图 老年患者 

分 类 号：R614.24[医药卫生—麻醉学]