胃镜检查前联合应用镇静镇痛药物的研究

STUDY OF SEDATION AND ANALGESIA FOR GASTROSCOPY

目的 :研究联合应用芬太尼和异丙酚或咪唑安定在胃镜检查中的镇静镇痛效果和安全性。方法 :将 132例胃镜检查患者随机分为Ⅰ组 (48例 ,给予芬太尼和异丙酚 )、Ⅱ组 (44例 ,给予芬太尼和咪唑安定 )和Ⅲ组 (对照组 ,40例 ,常规操作 ,不给镇静镇痛药 ) ,观察各组检查反应、操作时间、清醒时间及检查前、中、后血压、心率和SpO2 变化。结果 :Ⅰ、Ⅱ组的检查反应、操作时间明显优于Ⅲ组 (均为P <0 .0 0 5 ) ,Ⅰ组病人的清醒时间短于Ⅱ组 (P <0 .0 0 1)。Ⅰ、Ⅱ组病人检查中均有血压下降和心率减慢 ,但检查结束后恢复至检查前水平。结论 :胃镜检查前联合应用芬太尼和异丙酚或咪唑安定镇静镇痛是安全有效的 ,异丙酚 +芬太尼的清醒时间短于咪唑安定

Objective: To study the efficacy and safety of sedation and analgesia for gastroscopy with fentanyl and propofol or fentanyl and midazolam. Methods: A total of 132 patients was randomized into group I (n=48, given intravenous fentanyl and propofol), group II (n=44, given intravenous fentanyl and midazolam) and group III (the control group, n=40, without sedation and analgesia). Patient's feeling, operator's satisfaction, operative duration, the doses of fentanyl, propofol and midazolam, recovery time, blood pressure, heart rate and blood oxygen desaturation were recorded and analysed. Results: 48 patients in group I (100%), 42 patients in group II (95.5%) and 12 patients in group III (30%) didn't have any discomfort and pain for gastroscopy. Data in both group I and group II showed less discomfort, shorter operative duration as compared with the group III. The recovery time of group I was shorter than that of group II (2.5±1.9 minutes vs 5.0±2.4 minutes, p<0.001). The blood pressure and heart rate in both group I and group II were decreased during the procedure and recovered after the procedure. Conclusions: With intravenous use of fentanyl and propofol, or fentanyl and midazolam, gastroscopy can be achieved effectively, painlessly and safely. The recovery time was short in the patients with fentanyl and propofol.