Narcotrend监测下丙泊酚浅麻醉复合舒芬太尼用于老年患者肠镜检查的效果  

Effect of light propofol anesthesia combined with sufentanil on enteroscopy in elderly patients under Narcotrend monitoring

作　　者：靳永强[1] 王昊[2] 赵年章[1] 宗银东 JIN Yongqiang;WANG Hao;ZHAO Nianzhang;ZONG Yindong(Department of Anesthesia,the Fifth Affiliated Hospital of Guangzhou Medical University,Guangdong Province,Guangzhou 510700,China;不详)

机构地区：[1]广州医科大学附属第五医院麻醉科,广州市510700 [2]广州医科大学附属第五医院消化内科,广州市510700

出　　处：《临床合理用药杂志》2023年第4期27-31,35,共6页Chinese Journal of Clinical Rational Drug Use

基　　金：广东省医院药学研究基金项目(新晨舒适化医疗专项基金项目)(2020XC09);广州市卫计委西医类一般引导项目(20201A010069)。

摘　　要：目的观察Narcotrend(NT)监测下丙泊酚浅麻醉复合不同剂量舒芬太尼用于老年患者肠镜检查的麻醉效果。方法选取2020年3月—2021年5月广州医科大学附属第五医院拟行无痛肠镜检查的老年患者270例,按照随机数字表法分为A组、B组和C组,每组90例。3组均采用NT监测下丙泊酚靶控输入镇静,浅麻醉/意识深度维持在D_(0)~D_(1)阶段[即麻醉深度指数(NI)维持47~64]。A组、B组和C组患者静脉分别给予舒芬太尼0.05、0.1和0.15μg/kg镇痛。比较3组患者结肠镜进入乙状结肠(T_(1))、结肠脾曲(T_(2))、结肠肝曲(T_(3))、回盲部(T_(4))及退镜时(T_(5))生命体征和术中并发症,比较3组患者术中丙泊酚和心血管相关药物使用情况及术毕苏醒情况。结果3组患者麻醉后平均动脉压(MAP)均下降(P<0.05);A组患者T_(2)~T_(5)时MAP、心率(HR)均高于B和C组(P<0.05),B组与C组比较差异无统计学意义(P>0.05);术中A组患者体动、高血压、心动过速发生率高于B和C组(P<0.05),C组心动过缓发生率高于A组和B组(P<0.05);A组丙泊酚用量、乌拉地尔和艾司洛尔使用率均高于B组和C组(P<0.05);C组阿托品使用率高于A组和B组(P<0.05);术毕A组和C组苏醒时间和定向力恢复时间长于B组(P<0.05),C组患者术毕眩晕、恶心及疲劳发生率高于A组和B组(P<0.05)。结论NT监测下丙泊酚浅麻醉镇静下,舒芬太尼剂量0.1μg/kg即可提供舒适镇痛,术中呼吸循环较稳定,无术中知晓,患者苏醒快,术后并发症少,有利于门诊老年患者无痛肠镜检查。Objective To observe the anesthesia effect of light propofol anesthesia combined with different doses of sufentanil on enteroscopy in elderly patients under Narcotrend monitoring.Methods 270 elderly patients who were scheduled to undergo painless colonoscopy in the Fifth Affiliated Hospital of Guangzhou Medical University from March 2020 to May 2021 were selected,and they were divided into group A,group B and group C according to the random number table method,with 90 cases in each group.Three groups were sedated by propofol target-controlled infusion under NT monitoring,and the light anesthesia/consciousness depth was maintained at the D_(0)~D_(1) stage[the depth of anesthesia index(NI)was maintained at 47~64].Group A,group B and group C were given sufentanil 0.05,0.1 and 0.15μg/kg analgesia,respectively.The vital signs and intraoperative complications when colonoscopy entered the sigmoid colon(T_(1)),colon splenic flexure(T_(2)),colon hepatic flexure(T_(3)),ileocecal region(T_(4))and when the colonoscopy was withdrawn(T_(5))were compared among the three groups,the use of propofol and cardiovascular-related drugs during the operation and the recovery after the operation.Results Mean arterial pressure(MAP)decreased after anesthesia in the three groups(P<0.05);MAP and heart rate(HR)in group A were higher than those in group B and group C at T_(2)~T_(5)(P<0.05),there was no significant difference between group B and group C(P>0.05);During the operation,the incidences of body motion,hypertension and tachycardia in group A were higher than those in group B and group C(P<0.05),and the incidence of bradycardia in group C was higher than that in group A and group B(P<0.05);The dosage of propofol,the usage rates of urapidil and esmolol in group A were higher than those in group B and group C(P<0.05);the usage rates of atropine in group C were higher than those in group A and group B(P<0.05);The recovery time and orientation recovery time of group A and group C after surgery were longer than those of group B(P<0.05),and

关 键 词：老年患者 肠镜 Narcotrend监测 舒芬太尼 

分 类 号：R614[医药卫生—麻醉学]