阿芬太尼在无痛胃肠镜检查中的有效性和安全性分析  

Efficacy and safety of afentanil in painless gastroenteroscopy endoscopy

作　　者：王珊[1] 杨进国[2] 吴清海[2] 李志浩[1] WANG Shan;YANG Jinguo;WU Qinghai;LI Zhihao(Department of Pharmacy,Sinopharm Dongfeng General Hospital,Hubei University of Medicine,Shiyan,Hubei 442008,China;Department of Anesthesiology,Sinopharm Dongfeng General Hospital,Hubei University of Medicine,Shiyan,Hubei 442008,China)

机构地区：[1]湖北医药学院附属国药东风总医院药学部,湖北十堰442008 [2]湖北医药学院附属国药东风总医院麻醉科,湖北十堰442008

出　　处：《现代医药卫生》2023年第12期2036-2040,共5页Journal of Modern Medicine & Health

基　　金：湖北省卫生健康委员会中医药科研立项项目(ZY2021Q007)。

摘　　要：目的比较阿芬太尼和舒芬太尼用于胃肠镜操作的安全性和有效性。方法选择2021年3-9月行无痛胃肠镜检查的患者326例,采用随机数字表法将其分为阿芬太尼组(A组,163例)、舒芬太尼组(S组,163例)。术前A组静脉推注阿芬太尼5μg/kg,S组静脉推注舒芬太尼0.1μg/kg,1 min后缓慢推注丙泊酚2 mg/kg。立即评估观察者警觉/镇静改良评分量表(MOAA/S)评分,直至MOAA/S≤1分,开始进镜操作。过程中如有体动,追加丙泊酚0.5 mg/kg。记录患者麻醉起效时间、苏醒时间、操作时间、丙泊酚使用量;计算患者麻醉药品费用;记录患者对麻醉深度的满意程度、内镜置入顺利情况及是否出现抵抗评价麻醉效果;苏醒后疼痛评分;记录患者麻醉前(T_(0))、操作开始时(T_(1))和退镜时(T_(2))的血压(BP)、心率(HR)、呼吸频率(RR)和经皮动脉血氧饱和度(SpO_(2)),并记录操作期间异常体征和指标,记录操作完成后24 h内其他不良反应的发生情况。结果A组丙泊酚用量[(143.10±31.91)mg]明显少于S组[(168.19±50.95)mg],A组麻醉药品费用[(94.04±1.46)元]明显高于S组[(69.79±6.01)元],差异均有统计学意义(P<0.05);A组麻醉起效时间、苏醒时间、操作时间[(1.28±0.59)、(9.93±3.82)、(15.65±7.57)min]均短于S组[(1.64±1.12)、(11.29±4.02)、(19.68±9.23)min],差异均有统计学意义(P<0.05);2组患者及医师满意度方面比较,差异无统计学意义(P>0.05);A组和S组患者在T_(1)、T_(2)时的BP、HR、RR和SpO_(2)有不同程度的改变,但在造成心血管和呼吸系统不良影响或需要临床干预的比例方面,差异无统计学意义(P>0.05);24 h内2组各类不良反应的发生率比较,差异无统计学意义(P>0.05)。结论阿芬太尼与舒芬太尼联合丙泊酚均可安全有效地应用于无痛胃肠镜检查,阿芬太尼(5μg/kg)复合丙泊酚麻醉迅速、平稳、恢复快,且在安全性方面与舒芬太尼类似,在检查操作等短小手术麻醉中有明显�Objective To compare the safety and efficacy of alfentanil and sufentanil in painless gastrointestinal endoscopy.Methods A total of 326 patients who underwent painless gastroenteroscopy from March to September 2021 were selected and divided into the afentanil group(group A,163 cases)and the sufentanil group(group S,163 cases)by random number table method.Before surgery,the group A was intravenously injected with afentanil 5μg/kg,and the group S was intravenously injected with sufentanil 0.1μg/kg,and 1 minute later,propofol 2 mg/kg was slowly injected.The modified observer′s assessment of alert(MOAA/S)was assessed immediately until MOAA/S≤1,and the procedure was initiated.If there was movement during the process,add propofol 0.5 mg/kg.Anesthesia onset time,recovery time,operation time and the amount of propofol were recorded.Calculating the cost of narcotic drugs for patients;The patients′satisfaction with the depth of anesthesia,the smooth placement of endoscope and whether there was resistance were recorded to evaluate the anesthetic effect.Pain score after awakening,blood pressure(BP),heart rate(HR),respiratory rate(RR),and percutaneous oxygen saturation(SpO_(2))were recorded before anesthesia(T_(0)),at the start of surgery(T_(1)),and at exit(T_(2)).Abnormal signs and indicators were recorded during surgery,and the occurrence of other adverse reactions within 24 h after the completion of surgery.Results The dosage of propofol in the group A[(143.10±31.91)mg]was significantly less than that in the group S[(168.19±50.95)mg],and the cost of narcotic drugs in the group A[(94.04±1.46)yuan]was significantly higher than that in the group S[(69.79±6.01)yuan],with statistical significance(P<0.05).The onset time of anesthesia,recovery time and operation time of the group A[(1.28±0.59),(9.93±3.82),(15.65±7.57)min]were shorter than those of the group S[(1.64±1.12),(11.29±4.02),(19.68±9.23)min].The differences were statistically significant(P<0.05).There was no significant difference in patient and physici

关 键 词：阿芬太尼 舒芬太尼 丙泊酚 无痛胃肠镜 有效性 安全性 

分 类 号：R97[医药卫生—药品]