经内镜逆行胰胆管造影中清醒镇静麻醉的应用研究  

Sedation for ERCP with midazolam

作　　者：郝建宇[1] 王世鑫[1] 罗颖[1] 岳云[1] 刘宇宏[1] 王月增[1] 

机构地区：[1]首都医科大学附属北京朝阳医院消化科,100020

出　　处：《中华消化内镜杂志》2002年第6期331-332,共2页Chinese Journal of Digestive Endoscopy

摘　　要：目的 探讨咪唑安定镇静麻醉在逆行胰胆管造影检查(ERCP)中应用的可行性和价值。方法 120例行ERCP检查的患者,常规术前准备后肌肉注射咪唑安定0.15 mg/kg,20 min后开始检查,术中观察患者的生命体征和耐受程度,并进行镇静分级与评分(国际标准化方式OAA/S)。术后对患者进行遗忘率调查及医生和患者满意度的调查。结果 所有病例均能顺利完成操作。平均动脉压、心率、血氧饱和度无明显改变,不良反应明显减少。次日患者满意度达98％。结论 咪唑安定肌肉注射清醒镇静状态下进行ERCP检查治疗,可使患者更好的与医生进行配合,同时可使患者遗忘不良记忆,安全可靠。Objective To assess the conscious sedative effect of midazolam during the procedure of ERCP, in terms of general stress responses of the patients, the circulatory change, tolerance, patient cooperation and safety during and after the procedure. Method One hundred twenty patients undergoing standard ERCP using the same model of endoscope. Each patient received intramuscular injection of midazolam at 0. 15mg/kg 20 min before starting the procedures. The sedative score (OAA/S) and the major vital signs (mean arterial pressure( MAP) ,heart rate(HR) and atrerial oxygen saturation (SpO2) ) were recorded during and after the endoscopic procedure. The degree of amnesia of the patients and the extent of satisfaction on both patient and physician sides were also assessed. Results The procedures were successfully completed in all patients. There was no significant change in MAP,HR and SpO2 in these patients. The adverse reactions to the procedures were significantly reduced. No signs of respiratory suppression was observed among this group of patients during and in the immediate post procedure period. Conclusion Conscious sedation by intramuscular injection of midazolam at a dose of 0. 15mg/kg 20min before the ERCP ameliorates the stress of the patients , maintained and steady hemodynamic condition for the procedure and an amnesia status after the procedure. Hence, midazolam is a satisfactory consions selative agent applicable in the ERCP examination.

关 键 词：咪唑安定 镇静麻醉 胰胆管造影术 内窥镜逆行 

分 类 号：R614[医药卫生—麻醉学]