无痛胃镜技术在保健门诊中的应用

Propofol anesthesia for gastroscopy during healthcare examination

目的 探讨单用普鲁泊福或伍用小剂量芬太尼在胃镜检查中的麻醉效果。方法 选择保健门诊胃镜检查100例，随机分为A组（n=50）：普鲁泊福异丙酚1～2mg／kg静注；B组（n=50）：芬太尼0．05mg、异丙酚1～2mg／kg静注。观察BP、HR、RR、SpO2值，记录胃镜检查时间、苏醒时间和异丙酚的用量，待苏醒后询问检查中有无知晓、有无痛苦记忆，随访检查后恶心、呕吐情况。结果麻醉诱导后A、B两组SBP分别下降19．2％和20．1％，插胃镜时SpO2轻度下降，检查中呼吸循环平稳；两组检查中均无知晓、苏醒后无痛苦记忆；两组胃镜检查时间、苏醒时间、异丙酚用量差异无统计学意义（P〉0．05）；B组检查后恶心发生率高于A组（20％VS2％，P〈0．01），检查后B组5例（10％）呕吐，A组无一例呕吐。结论单用异丙酚静脉麻醉安全、无痛、舒适，适用于保健门诊胃镜检查。

Objective To explore the effect of single prepofol and prepofol combined by low dose of fentanyl intravenous anesthesia for gastroseopy. Methods One hundred patients who had gastmseopy measured were randomly assigned into group A （ prepofol 1 - 2 mg/kg iv. ） and group B （ fentanyl 0.05mg and prepofl 1 -2 mg/kg iv. ） with 50 eases each. The BP,HR,RR and SpO2 were monitored and reeovery quality from anesthesia was evaluated in the two groups. Results After induction of anesthesia,SBP decreased by 19.2% （group A） and 20.1% （group B）. SpO2 decreased slightly when examination start. BP, HR, RR, SpO2 remained stable during examination. It was no awareness during examination and no pain memory after awake in two groups. There were no differences in the doses of prepofol and in the time of examination and the awake time in the two groups （ P 〉 0.05 ）. The ineidenees of nausea in group B （20%） were significantly higher than that in group A （2%） ,and 5 eases （ 10% ） vomited in group B but non-ease in group A after examinations. Conclusion prepofol single intravenous anesthesia fit for healtheare gastreseopy examination with less sideeffect.