丙泊酚复合芬太尼在老年患者胃肠镜检查中的应用  

Application of propofol combined with fentanyl in gastrointestinal endoscopy in elderly patients

作　　者：李元春 黄海慧 余湘元 LI Yuanchun;HUANG Haihui;YU Xiangyuan(Department of Anesthesiology,Kunshan Dianshanhu People's Hospital,Kunshan 215300,China;Department of Anesthesiology,Kunshan First People's Hospital,Kunshan 215300,China;Department of Anesthesiology,Kunshan Second People's Hospital,Kunshan 215300,China)

机构地区：[1]昆山市淀山湖人民医院麻醉科,昆山215300 [2]昆山市第一人民医院麻醉科,昆山215300 [3]昆山市第二人民医院麻醉科,昆山215300

出　　处：《西北药学杂志》2023年第3期126-130,共5页Northwest Pharmaceutical Journal

基　　金：江苏省自然科学基金项目(编号:20197832)。

摘　　要：目的 探讨丙泊酚复合芬太尼在老年患者胃肠镜检查中的应用。方法 选取98例行胃肠镜检查的老年患者作为研究对象,用随机数字表法分为2组,每组49例。对照组予以丙泊酚麻醉,观察组予以丙泊酚复合芬太尼麻醉。比较2组患者麻醉相关指标,不同时间点[胃镜检查前(T_(0))、胃镜置入后(T_(1))、肠镜检查前(T_(2))、肠镜置入后(T_(3))、检查结束(T_(4))]的生命体征,检查前后应激状态及不良反应。结果 观察组患者的苏醒时间、离室时间和定向力恢复时间均短于对照组(P<0.05);观察组T_(1)、T_(2)、T_(3)和T_(4)的心率及平均动脉压均高于对照组(P<0.05);观察组检查后血清丙二醛(malondialdehyde,MDA)、促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)和皮质醇(cortisol,Cor)水平均低于对照组(P<0.05);2组不良反应发生率的差异无统计学意义。结论 丙泊酚复合芬太尼在老年患者胃肠镜检查中的麻醉效果较为理想,能有效维持患者的生命体征,缓解机体的应激状态,且不会增加不良反应的发生率,具有较高的安全性,具有一定临床价值。Objective To explore the application of propofol combined with fentanyl in gastrointestinal endoscopy in elderly patients.Methods A total of 98 elderly patients undergoing gastrointestinal endoscopy were enrolled as the research objects.According to random number table method,they were divided into control group(propofol anesthesia)and observation group(propofol combined with fentanyl anesthesia),49 cases in each group.The anesthesia-related indexes,vital signs at different time points[before gastroscopy(T0),after gastroscope placement(T1),before colonoscopy(T2),after colonoscope placement(T3),at the end of examination(T4)],stress state and adverse reactions before and after examination in the 2 groups were compared.Results The awakening time,time when leaving the room and orientation recovery time in observation group were all shorter than those in control group(P<0.05).At T1,T2,T3 and T4,heart rate(HR)and mean arterial pressure(MAP)in observation group were higher than those in control group(P<0.05).The levels of serum malondialdehyde(MDA),adrenocorticotropic hormone(ACTH)and cortisol(Cor)in observation group were lower than those in control group(P<0.05).The difference in the incidence of adverse reactions between the 2 groups was not statistically significant(P>0.05).Conclusion The anesthetic effect of propofol combined with fentanyl is ideal in elderly patients undergoing gastrointestinal endoscopy,which can effectively maintain vital signs,relieve stress state and will not increase the incidence of adverse reactions,with high safety and certain clinical value.

关 键 词：芬太尼 丙泊酚 胃肠镜检查 应激状态 

分 类 号：R971[医药卫生—药品]