咪达唑仑及合用芬太尼用于无痛内镜检查的比较

Clinical Comparison Between Midazolam and It Combined with Fentanyl on Painless Endoscopy

目的:比较单用咪达唑仑及合用芬太尼作胃、肠镜检查的临床麻醉效果和安全性。方法:要求行无痛胃、肠镜检查的患者400例,随机均分为咪达唑仑组(M)及咪达唑仑合用芬太尼组(MF)等两组。MF组先静注芬太尼0.05-0.1 mg,然后与M组相同缓慢静注咪达唑仑(50 mg·kg-1)至无睫毛反射,开始操作。监测并记录两组注药前、注药后1 min、5 min、15 min, 操作结束时各点的SBP,SPO2,HR,R;记录两组咪达唑仑总量,MF组芬太尼总量;两组镇痛效果,肢动情况,清醒后遗忘程度及不良反应。结果:操作中1 min,5 min的SPO2,SBP,R与操作前比较有统计学差异(P<0.05);咪达唑仑总量MF组明显低于M组(P<0.01);两组肢动发生率MF组(5%)明显低于M组(13%);两组呼吸抑制(SPO2<90%)发生率MF(12%),M (11%),无显著性差异(P>0.05)。结论:咪达唑仑合用芬太尼更适合纤维胃、肠镜检查。

Objective: To compare the clinical anaesthesic efficacy and safety at single midazolam and it combined with fentany in the checks of fibergastroscope and fibercolonoscope. Method: 400 patients receiving painless fiberoscopic checks of stomach and bowels were randomly divided into two groups as midazolam group (M) and it combined with fentanyl group (MF). At first, MF was given fentanyl 0.05 to 0. 1 mg intravenousy, then midazolam (0.5 μg·kg-1 ) be given for both groups by slow infusion until without ciliary' s reflex,ifpatient complained pain at the early phase of operation, fentany was used in MF group and midazolam in M group. The SBP, SPO2,HR,R in both groups before operation and during the following phase as 1, 5,15 min after injection were determined, also the same way was used for the end of operation, the total amount of midazolam in the two groups, total fentanyl dosage in MF group, analgesic effect, body movement, forget level after soberness and adverse reaction were recored. Result: There was a statistical difference in SPO2, SBP, R before and after drug-given, the overall amount of midazolam in MF group was obviously less than in MP group, the incidence of body movement in M group was obviouly less than in MP group, the incidence of respiratory inhibition (SPO2 <90% )were respectively 12% (MF group) and 11% (M group) without a significant difference. Conclusion: The combination of two drugs, midazolam and fenatany was more suitable for the checks of fibergastroscope and fibercolonoscope.