瑞芬太尼用于哺乳期妇女胃镜检查的麻醉对血浆泌乳素水平的影响  

Effect of Remifentanil on prolactin levels in plasma of lactating women for painless gastroscopy

作　　者：王冰[1] 黄焕森[2] 李长科[1] 

机构地区：[1]粤北人民医院麻醉科,广东韶关512026 [2]广州医科大学第二附属医院麻醉科,广东广州510260

出　　处：《安徽医药》2017年第10期1906-1909,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的观察瑞芬太尼联合丙泊酚对哺乳期妇女无痛胃镜检查中血流动力学、血浆泌乳素水平、复苏时间及不良反应的影响。方法选择90例哺乳期女性患者,美国麻醉医师协会(ASA)Ⅰ~Ⅱ级,将90例采用随机数字表法分为瑞芬太尼复合丙泊酚麻醉组(R组),芬太尼复合丙泊酚麻醉组(F组)和普通胃镜组(O组),每组各30例。记录三组患者麻醉开始前(T0)、检查开始前(T1)、胃镜过会厌时(T2)、胃镜退出时(T3)四个时间点的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_2);记录患者苏醒时间、离院时间及苏醒过程中恶心呕吐、头晕不良反应的发生率;抽血检测麻醉开始前(T0)、胃镜退出时(T3)及检查结束后24 h(T4)血浆泌乳素水平。结果与T0相比,R组与F组患者在T1时间点MAP、HR、SpO_2明显降低(P<0.05)。T2、T3时间点MAP、HR、SpO_2与T0比较,差异无统计学意义(P>0.05);而O组患者在T2、T3时间点MAP、HR与T0相比明显升高,差异有统计学意义(P<0.05);R组患者苏醒时间与离院时间较F组明显缩短(P<0.05);R组与F组患者在T3时间点血浆泌乳素水平远远高于O组(P<0.05),但R组与F组组间比较差异无统计学意义(P>0.05);R组检查结束后头晕、困倦感的发生率显著低于F组(P<0.05)。结论瑞芬太尼和芬太尼分别复合丙泊酚用于胃镜检查的麻醉均能有效抑制操作引起的应激反应,但瑞芬太尼能明显缩短苏醒时间和离院时间,提高苏醒质量,并且对血清泌乳素水平无不良影响,更适合哺乳期女性患者。Objective To observe the influences of remifentanil combined with propofol on hemodynamics,recovery time and plasma prolactin levels in lactating women receiving painless gastroscopy. Methods 90 patients( ASAⅠ-Ⅱ) receiving gastroscopy were divided into three groups: Group remifentanil( R group,n = 30),Group fentanyl( F group,n = 30) and Group ordinary gastroscopy( O group,n = 30). MAP,HR,SpO_2 of all patients before anesthesia,before the checking,the time of the gastroscope through the epiglottis,at the end of endoscopy were recorded. Recording recovery time of patient,plasma prolactin levels of before anesthesia,the end of endoscopy and 24 h after checking. Results MAP,HR,SpO_2 of R group and F group patients after anesthetic decreased transiently,but within the normal range. MAP,HR of O group patients increased significantly during the endoscopy; period of recovery and away from the recovery room of group R was significantly shorter than F; plasma prolactin levels of Group R and Group F at the end of endoscopy were much higher than Group O. Conclusions Remifentanil and fentanyl combined with propofol used for gastroscopy can effectively inhibit the stress response caused by the operation. However,remifentanil can significantly decrease the duration of the recovery,with no effect on PRL levels,which suitable for lactating patients.

关 键 词：瑞芬太尼 无痛胃镜 泌乳素 

分 类 号：R614[医药卫生—麻醉学]