超重患者行无痛胃镜麻醉中舒芬太尼和丙泊酚最佳给药时间间隔的临床观察  

Clinical observation on the optimal administration time of Sufentanil combined with Propofol in overweight patients undergoing painless gastroscopy

作　　者：李沛函 李丽[1] 杨彦伟 刘缚鲲[1] LI Pei-han;LI Li;YANG Yan-wei(Department of Anesthesiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院麻醉科,北京100050

出　　处：《临床和实验医学杂志》2020年第13期1362-1364,共3页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金(编号:81870926)。

摘　　要：目的探讨行无痛胃镜检查的超重患者选择舒芬太尼联合丙泊酚进行麻醉期间的最佳给药间隔时间。方法前瞻性选取2019年6月至2019年12月于首都医科大学附属北京友谊医院择期行无痛胃镜的超重患者(体重指数为25~29.9 kg/m^2)90例,ASA分级为Ⅰ级或Ⅱ级,采用随机数字表法将患者分为舒芬太尼和丙泊酚同时给药组(A1组)、舒芬太尼给药1 min后丙泊酚给药组(A2组)、舒芬太尼给药2 min后丙泊酚给药组(A3组),每组各30例。三组患者入室后静脉推注舒芬太尼0.05~0.1μg/kg,根据需要静脉推注丙泊酚每10秒推3 ml直至意识消失。记录各组患者给药后意识丧失所需时间、丙泊酚用量和手术后患者苏醒时间以及术中发生体动、呼吸抑制和心动过缓的情况。结果与A1组比较,A2组和A3组患者的丙泊酚用量(A1组112.33±9.26 mg,A2组93.17±6.76 mg,A3组99.00±4.81 mg)较少(P<0.05),其中A2组患者的丙泊酚用量最少(P<0.05);与A3组比较,A1组和A2组患者的意识消失时间(A1组28.90±1.47 s,A2组27.73±1.53 s,A3组30.80±1.86 s)较短(P<0.05),其中A2组患者的意识消失时间最短(P<0.05);与A1组比较,A2组和A三组患者的苏醒时间(A1组8.38±0.43 s,A2组6.88±0.54 s,A3组7.30±0.78 s)较短(P<0.05),其中A2组患者的苏醒时间最短(P<0.05);与A1组比较,A2组和A3组患者的体动发生例数(A1组16.667%,A2组3.333%,A3组26.667%)较少(P<0.05),A2组患者的体动发生例数最少(P<0.05);三组患者的围手术期呼吸抑制(A1组10.000%,A2组3.333%,A3组10.000%)和心动过缓(A1组13.333%,A2组6.667%,A3组10.000%)发生率比较,差异均无统计学意义(P>0.05)。结论在预充氧充分的情况下,舒芬太尼联合丙泊酚在超重患者行无痛胃镜麻醉中给药时间间隔应控制为1 min。Objective To investigate the optimal interval between administration of Sufentanil and Propofol for anesthesia in overweight patients undergoing gastroscopy.Methods Ninety overweight patients undergoing gastroscopy in our hospital from June 2019 to September 2019,with body mass index from 25 to 29.9 kg/m^2,American Society of Anesthesiologists(ASA)gradeⅠtoⅡ,were prospectively selected and divided randomly into Group A1(n=30):Sufentanil and Propofol were administered at the same time;Group A2(n=30):Propofol was administered 1 min after Sufentanil administration;Group A3(n=30):Propofol was administered 2 min after Sufentanil administration.All patents were administrated with 0.05~0.1μg/kg Sufentanil intravenously after entering the room,followed by 3 ml of propofol every 10 seconds until consciousness disappeared.Time needed for loss of consciousness,dosage of Propofol,wake-up time,body movement,respiratory depression and bradycardia were recorded separately.Results Compared with Group A1,the doses of propofol in Group A2 and Group A3 were lower(Group A1112.33±9.26 mg,Group A293.17±6.76 mg,Group A399.00±4.81 mg)(P<0.05),and the dose of propofol in Group A2 was the least(P<0.05).Compared with Group A3,Group A1 and Group A2 had shorter time of consciousness loss(Group A128.90±1.47 s,Group A227.73±1.53 s,Group A330.80±1.86 s)(P<0.05),and Group A2 had the shortest(P<0.05).Compared with Group A1,Group A2 and Group A3 had shorter wake-up time(Group A18.38±0.43 s,Group A26.88±0.54 s,Group A37.30±0.78 s)(P<0.05),and Group A2 had the shortest(P<0.05).Compared with Group A1,Group A2 and Group A3 had lower incidence of body movement(Group A116.667%,Group A23.333%,Group A326.667%)(P<0.05),and Group A2 had the lowest(P<0.05).There was no significant difference in the incidence of perioperative respiratory depression(Group A110.000%,Group A23.333%,Group A310.000%)and bradycardia(Group A113.333%,Group A26.667%,Group A310.000%)among the three groups(P>0.05).Conclusion Under the condition of adequate preoxygenation,th

关 键 词：超重患者 无痛胃镜检查 舒芬太尼 丙泊酚 给药间隔时间 

分 类 号：R614[医药卫生—麻醉学]