不同剂量阿芬太尼复合丙泊酚中长链脂肪乳注射液用于老年人无痛胃镜诊疗对复苏质量的影响  

Effect of different doses of alfentanil combined with propofol medium and long chain fat emulsion injection on the quality of resuscitation in painless gastroscopy diagnosis and treatment for the elderly

作　　者：李中云 韦晓艳 牙耀 文建乾 潘荣明 杨焱焰 邓良 梁彬 LI Zhongyun;WEI Xiaoyan;YA Yao;WEN Jianqian;PAN Rongming;YANG Yanyan;DENG Liang;LIANG Bin(Department of Anesthesiology,the Third People's Hospital of Nanning,Nanning 530003,Guangxi,China)

机构地区：[1]广西南宁市第三人民医院麻醉科,广西南宁530003

出　　处：《右江医学》2023年第8期697-700,共4页Chinese Youjiang Medical Journal

基　　金：广西壮族自治区卫生健康委员会自筹经费科研项目(Z20210503)。

摘　　要：目的评价不同剂量阿芬太尼复合丙泊酚中长链脂肪乳注射液用于老年患者无痛胃镜诊疗的复苏质量。方法选择2022年3月—12月南宁市第三人民医院ASAⅠ~Ⅲ级拟在静脉全身麻醉下行胃镜诊疗的老年患者120例,年龄65~79岁,体重45~70 kg,性别不限,采用随机数字表分为四组(每组30例):对照组(C组)及不同剂量阿芬太尼组(F5组、F7组和F9组)。F5组、F7组、F9组分别静脉注射阿芬太尼5μg/kg、7μg/kg、9μg/kg(各组均用生理盐水稀释至0.1 mL/kg),C组静脉注射等量生理盐水,1 min后各组再缓慢推注丙泊酚中长链脂肪乳注射液0.8 mg/kg。术中出现呛咳或体动反应时,静脉追加丙泊酚中长链脂肪乳注射液0.4 mg/kg。记录各组诊疗时间、苏醒时间、复苏时间、丙泊酚中长链脂肪乳注射液追加情况及不良反应的发生情况。结果四组患者头晕、恶心呕吐及心动过缓的发生率比较差异无统计学意义(P>0.05)。与C组比较,F5组、F7组和F9组丙泊酚中长链脂肪乳注射液追加例数明显减少,苏醒时间和复苏时间明显缩短,体动、呼吸抑制和低血压发生率明显降低(P<0.05)。与F5组比较,F7组和F9组丙泊酚中长链脂肪乳注射液追加例数明显减少(P<0.05),体动反应、呼吸抑制及低血压发生率则差异无统计学意义(P>0.05)。与F7组比较,F5组和F9组苏醒时间、复苏时间明显延长(P<0.05)。结论阿芬太尼5μg/kg、7μg/kg、9μg/kg复合丙泊酚中长链脂肪乳注射液用于老年人无痛胃镜诊疗效果均较好,但阿芬太尼7μg/kg复苏质量更高、更安全。Objective To investigate the effects of different doses of alfentanil combined with propofol medium and long chain fat emulsion injection on the quality of resuscitation in painless gastroscopy diagnosis and treatment for the elderly.Methods 120 elderly patients with ASA(the American Society of Anesthesiologists)gradeⅠtoⅢwho planned to undergo gastroscopy under intravenous general anesthesia at the Third People's Hospital of Nanning from March to December 2022 were selected.Regardless of gender,the ages of them were 65-79 years,weights were 45-70 kg.These patients were randomly divided into 4 groups(n=30)by random number table:control group(group C)and different doses of alfentanyl groups(group F5,group F7,and group F9).Alfentanil was diluted with saline solution to 0.1 mL/kg,and then the group F5,the group F7,and the group F9 were given intravenous injection of 5μg/kg,7μg/kg,and 9μg/kg of alfentanil,respectively.The group C were injected with an equal amount of physiological saline intravenously,and after 1 minute,each group were slowly injected with propofol medium and long chain fat emulsion injection(0.8 mg/kg).When coughing or body movement reactions occurred during surgery,intravenous infusion of propofol medium and long chain fat emulsion injection(0.4 mg/kg)was added.And then,diagnosis and treatment time,awakening time,resuscitation time,additional use of propofol medium and long chain fat emulsion injection,and occurrence of adverse reactions in each group were recorded.Results There was no statistically significant difference in the incidence of dizziness,nausea and vomiting,and bradycardia among the four groups(P>0.05).Compared with the group C,the number of additional cases of propofol medium and long chain fat emulsion injection significantly decreased,awakening time and resuscitation time significantly shortened,and the incidence of movement,respiratory depression and hypotension also decreased significantly in the group F5,the group F7,and the group F9(P<0.05).Compared with the group F5,the

关 键 词：阿芬太尼 丙泊酚中长链脂肪乳注射液 复苏质量 胃镜诊疗 老年 

分 类 号：R614.2[医药卫生—麻醉学] R573[医药卫生—外科学]