不同剂量地佐辛复合丙泊酚用于胃镜检查的临床观察  

Clinical Observation of Different Doses of Dezocine Combined with Propofol for Gastroscopy

作　　者：姚活锋[1] 黄焕森[1] 

机构地区：[1]广州医科大学附属第二医院,广东广州510260

出　　处：《现代医院》2017年第2期271-273,共3页Modern Hospitals

摘　　要：目的探讨不同剂量地佐辛复合丙泊酚全凭静脉麻醉在胃镜检查中应用效果。方法行胃镜检查成年患者90例,随机分为3组,每组30例。麻醉用药:D1组给予地佐辛30μg/kg,D2组给予地佐辛40μg/kg,S组给予舒芬太尼0.1μg/kg,3组均在2 min后静注丙泊酚1.5 mg/kg,1 min后施行胃镜检查。患者如出现体动立即追加丙泊酚至体动消失。记录各组患者麻醉前、麻醉后1 min及入镜时的HR、RR、MAP、Sp O2变化;检查中体动情况、丙泊酚用量、操作时间、苏醒时间及苏醒后10、30、60 min等时间点的头晕、恶心、呕吐等副作用发生情况。结果 3组组内比较,麻醉后的HR及MAP比麻醉前均减慢或下降(P<0.05);麻醉后和入镜时RR均较麻醉前减慢,差异有统计学意义(P<0.05);组间比较,3组患者麻醉后、入镜时的HR、RR、MAP及Sp O2比较差异无统计学意义(P>0.05)。D2组和S组丙泊酚用量及体动发生率均比D1组少(P<0.05);D1组和D2组患者苏醒时间均比S组延长(P<0.05);S组苏醒后10 min头晕发生率高于D1和D2组(P<0.05)。结论地佐辛30、40μg/kg及舒芬太尼0.1μg/kg复合丙泊酚1.5 mg/kg均能满足胃镜检查无痛麻醉,安全有效,但地佐辛40μg/kg组具有检查中体动发生率低、镇痛作用良好、头晕发生率低等优点。Objective To investigate the effects of different doses of dezocine combined propofol with depends on the clinical application effect of intravenous anesthesia in gastroscopy. Methods 90 adult patients were randomly divided into three groups （in each group n = 30）. Anesthetic medication given 30 p.g/kg dezocine as D1 group, and D2 group received dezocine 40 p,g/kg. S group was given sufentanil 0.1 p,g/kg, and three groups were intravenous injection of propofol 1.5 rag/ kg after 2 min, 1 min after gastroscope inspection. If patients have body movements, propofol was immediately added to the body movements disappear. Recorded the changes of HR, RR, MAP, SpO2 before and after anesthesia 1 rain and into the mirror in each group; the body movement, the dosage of propofol, the operation time, recovery time and recovery after 10, 30, 60 min time, dizziness, nausea and vomiting occurred. Results The compare of the three groups, HR and MAP after anesthesia than before anesthesia decreased after anesthesia （ P 〈 0. 05 ） ; The RR when patients were in gastroscopy and after anesthesia was decreased than that before anesthesia, the difference was statistically significant （P 〈 0. 05 ） ; Comparison be- tween groups, when patients of the three groups were anesthetized,and in gastroscopy,the HR, RR, MAP and SpO2 had no significant difference （ P 〉 0.05 ）. D2 group and S group, the dosage of propofol and the rate of body movement was less than the D1 group （P 〈0. 05） ; D1 group and D2 group patients recovery time was longer than S group （P 〈0. 05） ; Group S pro- longed 10 rain after awakening dizziness occurrence rate was higher than D1 and D2 group （ P 〈 0. 05 ）. Conclusion Dezo- cine 30, 40 μg/kg or sufentanil 0. 1 μg/kg combined with propofol 1.5 mg/kg can meet the painless gastroscopy anesthesia is safe and effective, but dezocine group 40 μg/kg has the inspection body movement rate is low, good analgesic effect, low incidence of dizziness.

关 键 词：地佐辛 丙泊酚 无痛胃镜 

分 类 号：R971.2[医药卫生—药品] R443.8[医药卫生—药学]