依托咪酯联合不同剂量阿芬太尼在老年患者无痛超声胃镜检查中的应用研究  

Application study of etomidate combined with different doses of alfentanil in painless ultrasound gastroscopy of elderly patients

作　　者：蓝青海 陈以建[1] 邓思敏 梁伟东 LAN Qinghai;CHEN Yijian;DENG Simin;LIANG Weidong(Department of Anesthesiology,the People’s Hospital of Ganzhou,Ganzhou 341000,China;Department of Anesthesiology,the First Hospital affiliated to Gannan Medical College,Ganzhou 341000,China)

机构地区：[1]赣州市人民医院麻醉科,赣州341000 [2]赣南医学院第一附属医院麻醉科,赣州341000

出　　处：《上海医药》2024年第9期69-73,共5页Shanghai Medical & Pharmaceutical Journal

基　　金：江西省赣州市卫生健康委员会科研计划项目(2020-2-32)。

摘　　要：目的:探讨依托咪酯联合不同剂量阿芬太尼用于老年患者无痛超声胃镜检查中的应用效果。方法:将120例行无痛超声胃镜检查的老年患者随机分为S、A及B组各40例,S组给予依托咪酯麻醉,A组及B组分别给予依托咪酯联合阿芬太尼5μg/kg、10μg/kg麻醉。记录3组依托咪酯用量、检查时长及苏醒时间;记录诱导前、检查即刻、诱导后5 min、诱导后10 min、检查结束时的生命体征,以及不良事件发生情况。结果:A组和B组术中依托咪酯用量均少于S组(P<0.05),而A组与B组无明显差异(P>0.05);术后苏醒时间方面,A组<S组<B组(P<0.05);A组呼吸抑制、循环抑制的发生比例低于B组(P<0.05);A和B组注射痛、肌阵挛发生比例均明显少于S组(P<0.05);而B组低血压发生率较高(P<0.05)。结论:依托咪酯联合低剂量(5μg/kg)阿芬太尼用于老年患者无痛超声胃镜检查安全有效,不良反应较少。Objective:To investigate the application effect of etomidate combined with different doses of alfentanil in painless ultrasonic gastroscopy of elderly patients.Methods:One hundred and twenty elderly patients who underwent painless ultrasound gastroscopy were randomly divided into group S,A and B with 40 cases each.Group S was given etomidate for anesthesia,and group A and B were given etomidate combined with alfentanil 5 or 10 mg/kg for anesthesia,respectively.The dosage of etomidate,length of examination and awakening time in the three groups were recorded;vital signs before induction,immediately after examination,5 and 10 min after induction,and at the end of examination and the incidence of adverse events were also recorded.Results:The intraoperative dosage of etomidate in group A and B was less than that in group S(P<0.05),whereas there was no significant difference between group A and B(P>0.05).The postoperative awakening time was in group A<group S<group B(P<0.05).The proportion of respiratory depression and circulatory suppression in group A was lower than that in group B(P<0.05).The proportions of injectable pain and myoclonus in group A and B were significantly less than that in group S(P<0.05),while the incidence of hypotension was higher in group B(P<0.05).Conclusion:Etomidate combined with low-dose(5 mg/kg)alfentanil is safe and effective for painless ultrasound gastroscopy in elderly patients with fewer adverse effects.

关 键 词：老年患者 无痛超声胃镜 阿芬太尼 依托咪酯 

分 类 号：R971.2[医药卫生—药品] R573[医药卫生—药学]