异丙酚和咪唑安定在胃镜检查中的应用研究

Study on painless gastroscopy with propofol and midazolam

目的 研究联合应用异丙酚和咪唑安定在胃镜检查中的镇静效果和安全性。方法胃镜检查患者1 915例给予异丙酚和咪唑安定镇静,640例予常规操作(不给任何镇静药),比较2组胃镜检查中患者反应和感受、操作时间,观察其清醒时间及检查前、中、后血压,心率和血氧饱和度变化。结果 镇静组患者99.2％无不适,而对照组为35.0％(P<0.01)。镇静组患者咳嗽、躁动、恶心呕吐和咽喉不适的发生率分别为1.1％、0.8％、0.5％与0％,明显低于对照组(分别为5.0％、5.3％、45.0％与37.5％,P<0.01),镇静组胃镜操作时间为(4.5±1.5)min,短于对照组(5.6±1.8)min,(P<0.01)。镇静组患者清醒时间为(1.4±1.3)min,检查中有血压下降,但检查结束后迅速恢复至检查前水平。结论胃镜检查时适量应用异丙酚和咪唑安定静脉镇静,是一种安全、有效的方法。

Objective To study the efficacy and safety of sedation for gastroscopy with a combined use of propofol and midazolam compared to a control, non-sedative group , with the goal of establishing a method of painless gastroscopy. Methods One thousand nine hundred fifteen patients in sedative group were given intravenous propofol and midazolam . Patients feeling and discomfort, operators satisfaction and operative duration were compared with the control group ( n = 640, without sedation ) . The changes of blood pressure, heart rate and blood oxygen saturation were recorded and analysed. Results One thousand nine hundred patients(99. 2% ) in sedative group and 224 patients(35. 0% ) in control group did not complain any discomfort and pain during gastroscopy(P <0. 01). The incidence of cough, restlessness, nausea and vomiting, and guttural discomfort in sedative group( 1. 1% ,0. 8% ,0. 5% and 0% ,respectively) was lower as compared with the control group(5. 0% .5. 3% ,45. 0% and 37. 5% ,respectively, P <0. 01). The operative duration of sedative group was shorter than that of control group. The recovery time of sedative group was ( 1.4±1. 3 ) minutes. The blood pressure in sedative group was decreased during the procedure and recovered after the procedure. Conclusion With intravenous use of propofol and midazolam , gastroscopy can be performed effectively and safely.