不同剂量阿芬太尼复合丙泊酚在无痛膀胱镜检查中的临床应用效果  

Clinical application of different doses of alfentanil combined with propofol in painless cystoscopy

作　　者：康帅[1] 裴大庆 周红梅[1] 孙家林 KANG Shuai;PEI Da-qing;ZHOU Hong-mei(Department of Anesthesiology,the Second Affiliated Hospital of Jiaxing University,Jiaxing,Zhejiang(314000),China)

机构地区：[1]浙江省嘉兴学院附属第二医院麻醉科,浙江嘉兴314000

出　　处：《中国中西医结合外科杂志》2023年第1期43-46,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:研究不同剂量阿芬太尼复合丙泊酚在无痛膀胱镜检查术中的临床应用效果。方法:选取2021年1月—2021年12月在我院行静脉全麻下膀胱镜检查的患者105例,采用随机数字表法将患者随机分为A组、B组和C组,分别采用阿芬太尼5μg/kg、7.5μg/kg和10μg/kg复合丙泊酚麻醉,目标镇静深度为改良警觉/镇静评分(MOAA/S)≤2分。记录膀胱镜检查中检查时间、低氧血症发生率、不自主体动事件、低血压、心动过缓、术后恶心、头晕发生率、术后尿路刺激征发生率、中重度尿路刺激征发生率、镇静成功率、丙泊酚用量、血管活性药物使用人数、诱导时间、苏醒时间及满意度评分。结果:C组患者术中低氧血症发生率明显高于B组(25.0%vs 3.2%,P<0.05);A组低血压发生率显著高于B组(32.4%vs 9.7%,P<0.05),A组心动过缓发生率(35.3%)显著高于B组(12.9%)、C组(12.5%),差异有统计学意义;A组尿路刺激征发生率(67.6%)显著高于B组(35.5%)、C组(25.0%),差异有统计学意义。A组丙泊酚用量、血管活性药人数及苏醒时长均显著高于B、C组,差异有统计学意义;3组患者的镇静成功率、中重度尿路刺激征及满意度评分差异均无统计学意义。结论:阿芬太尼7.5μg/kg复合丙泊酚麻醉在无痛膀胱镜检查中安全有效,麻醉效果较好。Objective To investigate the clinical effect of different doses of alfentanil combined with propofol in painless cystoscopy. Methods One hundred and five patients of both sexes, aged 30-75 years old, of ASA physical status I or Ⅲ, scheduled for elective cystoscopy under intravenous general,were randomly divided into group A, group B and group C by random number table method(n=35 each). Groups A, B and C were anesthetized with alfentanil 5 μg/kg, 7. 5 μg/kg and 10 μg/kg combined with propofol respectively,and the target sedation depth was MOAA/S ≤ 2 points. The incidence of hypoxemia, hypotension, bradycardia,involuntary movement events, sedation success rate, number of vasoactive drug users, propofol dosage, induction time, examination time, recovery time, operation time during cystoscopy were recorded. The incidence of posterior urinary tract irritation, moderate to severe urinary tract irritation and postoperative nausea and dizziness.Results The incidence of intraoperative hypoxemia in group C was significantly higher than that in group B(25.0% vs 3.2%, P<0.05);the incidence of hypotension in group A was significantly higher than that in group B(32.4% vs 9.7%, P<0.05), the incidence of bradycardia was significantly higher than that in groups B and C(both P<0.05);the incidence of urinary tract irritation in group A was significantly higher than that in groups B and C(both P<0.05). The dosage of propofol, the number of vasoactive drugs and the recovery time in group A were significantly higher than those in groups B and C(all P<0.05);the three groups were different in terms of sedation success rate, moderate to severe urinary tract irritation and satisfaction score. There were no statistical significances(P>0.05). Conclusion Alfentanil 7.5 μg/kg combined with propofol anesthesia is safe and effective in painless cystoscopy, and the anesthesia effect is better.

关 键 词：阿芬太尼 丙泊酚 膀胱镜检查 低氧血症 尿路刺激征 

分 类 号：R614[医药卫生—麻醉学]