不同镇痛药物预注射联合丙泊酚在门诊无痛胃镜检查中的应用研究  

Study on Application of Different Analgesics Pre-injection Combined with Propofol in Painless Gastroscopy of Outpatients

作　　者：修雪莉 刘凤妍 施沃维 温福腾 XIU Xueli;LIU Fengyan;SHI Wowei;WEN Futeng(Heshan People’s Hospital,Heshan 529700,China;不详)

机构地区：[1]广东省鹤山市人民医院,广东鹤山529700

出　　处：《中国医学创新》2020年第24期9-14,共6页Medical Innovation of China

基　　金：江门市卫生计生局科学技术研究项目(19A120)。

摘　　要：目的:探讨不同镇痛药物预注射联合丙泊酚在门诊无痛胃镜检查中的应用效果。方法:选取2019年4月-2020年1月在本院门诊行无痛胃镜检查的400例患者,随机分为四组,对照组直接注射丙泊酚,研究1组预注射舒芬太尼,研究2组预注射利多卡因,研究3组预注射舒芬太尼联合利多卡因,比较四组镇痛效果与各指标。结果:与对照组相比,研究1、2、3组疼痛发生率、VAS评分均较低(P<0.05);与研究1、2组相比,研究3组疼痛发生率、VAS评分均较低(P<0.05);与对照组相比,研究1、2、3组丙泊酚总用量、术后意识恢复时间均较低(P<0.05);与研究1、2组相比,研究3组丙泊酚总用量、术后意识恢复时间均较低(P<0.05);虽然研究3组不良反应发生率高于对照组、研究1组与研究2组,四组比较差异无统计学意义(P>0.05);研究1、2、3组T1~T2时MAP无差异,研究1、2、3组T2时HR无差异,但对照组T1~T2时MAP明显下降后又明显升高(P<0.05)、T2时HR明显升高(P<0.05),研究3组T0~T3时MAP、HR、SpO2浮动均较小(P>0.05)。结论:在门诊无痛胃镜检查麻醉药物使用中,与单用丙泊酚相比,预注射舒芬太尼或利多卡因均能降低疼痛发生率,缓解丙泊酚注射痛,减少丙泊酚总用量,且血流动力学相对较稳定,特别是将舒芬太尼、利多卡因、丙泊酚联合使用时,麻醉镇痛效果最优,对患者血流动力学基本无明显影响。在丙泊酚前预注射舒芬太尼和/或利多卡因不失为一种安全可行的方法,值得临床推广。Objective:To explore the application effects of different analgesics pre-injection combined with Propofol in painless gastroscopy of outpatients.Method:From April 2019 to January 2020,400 outpatients with painless gastroscopy were randomly divided into four groups:the control group was directly injected with Propofol,the study 1 group was pre-injected with Sufentanil,the study 2 group was pre-injected with Lidocaine,and the study 3 group was pre-injected with Sufentanil and Lidocaine,the analgesic effects and indexes of four groups were compared.Result:Compared with the control group,the incidence of pain and VAS score among the study 1,2 and 3 groups were lower(P<0.05).Compared with the study 1 and 2 groups,the incidence of pain and VAS score in the study 3 group were lower(P<0.05).Compared with the control group,the total amount of Propofol and the time of consciousness recovery among the study 1,2 and 3 groups were lower(P<0.05).Compared with the study 1 and 2 groups,the total amount of Propofol and the time of consciousness recovery in the study 3 group were lower(P<0.05).Although the incidence of adverse reactions in the study 3 group was higher than those in the control group,the study 1 and 2 groups,but there was no significant difference among four groups(P>0.05).There were no differences in MAP at T1-T2 among the study 1,2 and 3 groups,and there was no difference in HR among the study 1,2 and 3 groups at T2,but MAP in the control group at T1-T2 decreased and then increased significantly(P<0.05)and HR at T2 was significantly increased(P<0.05).There were no differences in MAP,HR and SpO2 in the study 3 group at T0-T3(P>0.05).Conclusion:Compared with Propofol alone,Sufentanil or Lidocaine pre-injection can reduce the incidence of pain,relieve the pain of Propofol injection,reduce the total dosage of Propofol,and the hemodynamics is relatively stable,especially when Sufentanil,Lidocaine and Propofol are used together,the effect of anesthesia and analgesia is the best,and the patient’s blood is the best,the

关 键 词：无痛胃镜检查 麻醉药物 丙泊酚 注射痛 舒芬太尼 利多卡因 

分 类 号：R614[医药卫生—麻醉学]