依托咪酯复合咪哒唑仑或芬太尼在老年患者无痛结肠镜手术麻醉中的效果分析  

Effect of etomidate combined with midazolam and fentanyl on anesthesia in elderly patients undergoing painless colonoscopy

作　　者：王盛华[1] 杨德军[1] 王鹏[1] Wang Shenghua;Yang Dejun;Wang Peng(Nanyang Second People's Hospital,Nanyang 473000,Henan,China)

机构地区：[1]南阳市第二人民医院,河南南阳473000

出　　处：《临床心身疾病杂志》2020年第3期156-158,共3页Journal of Clinical Psychosomatic Diseases

摘　　要：目的比较依托咪酯联合咪唑达伦或芬太尼在老年患者无痛结肠镜手术麻醉中的效果.方法将168例拟行无痛结肠镜手术的老年患者按随机数字表法将分为两组,每组84例.A组采用依托咪酯联合咪达唑伦麻醉,B组采用依托咪酯联合芬太尼麻醉,比较两组患者围麻醉期不同时点的心率、血压、脉搏血氧饱和度、体温、尿量指标、术后苏醒时间及麻醉不良反应发生状况.结果围麻醉期两组患者心率、血压、体温、脉搏血氧饱和度、尿量均出现一定程度的波动,但两组比较差异无统计学意义(P>0.05).A组患者苏醒时间显著长于B组(P<0.01).两组麻醉不良反应发生率比较差异无统计学意义(P>0.05),A组麻醉不良反应以嗜睡、共济失调、头痛、肌肉抽搐为主,B组以恶心、呕吐、眩晕、视物模糊为主.结论依托咪酯联合咪达唑仑与依托咪酯联合芬太尼用于老年无痛结肠镜手术麻醉效果均较好,麻醉不良反应类型不同,依托咪酯联合咪达唑仑对患者的镇静作用更强,术后苏醒时间较长.Objective To compare the effect of etomidate combined with midazolam and fentanyl on anesthesia in elderly patients undergoing painless colonoscopy.Methods 168 elderly patients who planned to undergo painless colonoscopy were divided into two groups according to the random number table method,with 84 patients in each group.Group A was treated with etomidate combined with midazolam anesthesia,group B was treated with etomidate and fentanyl anesthesia.The heart rate,blood pressure,SPO2,body temperature,urine volume index,postoperative wake-up time,and adverse reactions of anesthesia were compared at different time points between the two groups of patients.Results During the peri-anaesthesia period,the heart rate,blood pressure,body temperature,SPO2,and urine output fluctuated to some extent,but there was no significant difference between the two groups(P>0.05).The wake-up time of patients in group A was significantly longer than that in group B(P<0.01).There was no significant difference in the incidence of adverse reactions to anesthesia between the two groups(P>0.05).Adverse reactions to anesthesia in group A were mainly drowsiness,ataxia,headache,muscle twitching,and group B were mainly nausea,vomiting,dizziness,and blurred vision.Conclusions Etomidate combined with midazolam and etomidate combined with fentanyl have good anesthesia effects in elderly painless colonoscopy,with different types of adverse reactions.Etomidate combined with midazolam has a stronger sedative effect and a longer wake-up time.

关 键 词：无痛结肠镜手术 老年患者 依托咪酯 枸橼酸芬太尼 咪达唑仑 麻醉效果 不良反应 

分 类 号：R574.62[医药卫生—消化系统] R971.2[医药卫生—内科学]