丙泊酚联合咪唑安定、瑞芬太尼在胃镜与结肠镜中的运用比较

目的通过对丙泊酚联合咪唑安定、瑞芬太尼用于无痛纤维胃镜和结肠镜检查的研究。探讨其安全性和有效性及二者在麻醉处理上的异同。方法ASAⅠ～Ⅱ级的两组患者各50例,观察记录麻醉前、用药2min后、检查术中及手术结束后3min的HR、SBP、SpO2、RR、术毕清醒时间和丙泊酚用量。结果两组病人在用药2min后,HR、SBP均出现一定程度的下降,组内比较差异有统计学意义(P<0.05)。检查术中结肠镜组HR、SBP较前进一步下降,组内、组间比较差异有统计学意义(P<0.05)。结肠镜与胃镜相比,应用丙泊酚的首次剂量和总量更少(P<0.05)。结论丙泊酚联合咪唑安定、瑞芬太尼应用于胃镜与结肠镜检查能达到良好的麻醉镇痛的效果。胃镜与结肠镜对麻醉深度要求不尽相同,麻醉用药量与术中管理应符合各自的麻醉特点。

Objective To evaluate the efficiency and safety of propofoi combined with midazolam and remifentanil used in gastroscopy and colonoscopy, find the difference between them in anesthesia. Methods 50 patients in ASA Ⅰ-Ⅱ grade were choosen for gastroscopy and colonoscopy each, and the systolic pressure, heart rate, SpO2, respiratory rate, waking time and dose of propofoi were recorded in different time. Results HR, SBP decreased significantly 2 minutes after drug administration in two groups （P〈0.05）. HR, SBP come down further in the operating process of coionoscopy, there was significant difference between two groups. The dose of propofoi was less in colonoscopy （P〈0.05）. Conclusion Propofoi combined with midazolam and remifentanil used in gastroscopy and colonoscopy could offer a good sedation and analgesia. The treatment of analgesia is different between gastroscopy and colonoscopy.