摘要
[目的]探讨以异丙酚复合芬太尼实施监护下麻醉管理(Monitored Anesthesia Care,MAC)技术,应用于胃镜检查中的有效性和安全性。[方法]520例行胃镜检查者随机分为MAC组和对照组(n=260),对照组以2%利多卡因胶浆液行口咽表面麻醉后行胃镜检查。MAC组表麻后以芬太尼1μg/kg静脉注射,继以异丙酚1—2mg/s速度推注,Ramsav镇静分级4~5级后行胃镜检查,术中5—10mg/min速度维持MAC。[结果]MAC组无痛率100%,其中安静入睡213例(82%),轻微肢体活动26例(10%),明显肢体活动影响操作21例(8%),清醒时间短,不良反应少,检查中生命体征平稳。对照组病例则有不同程度的15/咽食道疼痛或不适,不良反应多。[结论]异丙酚复合芬太尼MAC技术应用于胃镜检查,镇痛镇静效果确切,安全。
[ Objective] To investigate the effect and safety of monitored anesthesia care( MAC)by Propofol combined with Fentanyl in gastroscopy. [ Methods] AU 520 patients attending for gastroscopy were randomly chosen and divided into control group(n = 260)and MAC group(n= 260). Control group underwent throat local anaesthesia by Lidocaine Hydrochloride Mucilage before normal gas- troscopy. MAC group was given Fentanyl ( 1μg/kg) and Propofol ( 1 - 2 mg/s) intravenously after throat local anaesthesia. If the patients reached class Ⅳ-Ⅴ of Ramsay score, inserted the gastroscope, and maintained with Propofol 5 - 10 mg/min. [Results] In M AC group , painless percentage was 100 %, 213 patients ( 82 % ) was sedately asleep, 26 patients ( 10 % ) had low - grade body movement,21 patient(8% ) had obvious body movement, awake time was short, and the vital signs were stable during gastroscopy. In con- trol group,all patients felt throat ache or discomfort. The incidence of bad resction in controlgroup was higher than that in MAC group. [Conclusion] The application of MAC by Propofol combined with Fentanyl in gastroscopy is safe,comfortable and effective.
出处
《大连医科大学学报》
CAS
2006年第3期203-204,207,共3页
Journal of Dalian Medical University