瑞芬太尼联合丙泊酚在胃镜检查中的应用

Study on painless gastroscopy with rimifentani and propofol

目的研究瑞芬太尼和丙泊酚联合用于胃镜检查的镇静效果和安全性。方法胃镜检查患者120例给予瑞芬太尼和丙泊酚（镇静组），对照组120例常规操作（不给任何镇静药），比较两组胃镜检查过程中患者的反应和感受，观察其清醒时间及检查前、中、后血压、心率、血氧饱和度变化。结果镇静组患者98．3％无不适，而对照组为0（P〈0．01）。镇静组咳嗽、躁动、恶心呕吐和咽喉不适的发生率分别为1．7％、3．3％、1．7％与0，明显低于对照组（9．2％、26．7％、48．3％与100％）（P〈0．01），检查中有血压下降，但检查结束后迅速恢复至检查前水平。结论胃镜检查时应用瑞芬太尼和丙泊酚静脉镇静是一种安全、有效的方法。

Objective To study the efficacy and safety of sedation in gastroscopy with a combined use of rimifentani and propofol compared to a control,non-sedative group. Methods 120 cases in sedative group were given intravenous rimifentani and propofol. Patients＇ feeling and discomfort,operator＇s satisfaction and operative duration were compared with the control group（ n = 120, without sedation）. The changes of blood pressure, heat rate and blood oxygen saturation were recorded and analysed. Results 118 patients（98.3 % ） in sedative group and 0 patient （0） in control group did not complain any discomfort and pain duing gastroscopy（P 〈 0.01 ）. The incidence of cough, restlessness, nausea and vomiting, and guttural discomfort in sedative group （ 1.7 %, 3.3 %, 1.7 %, and 0, respectively） was lower as compared with the control group （ 9.2 %, 26.7 % , 48.3 % and 100 % , respectively, P 〈 0.01）. The blood pressure in sedative group was decreased duing the procedure and recovcred after the procedure. Conclusion With intravenous use of rimifentani and propofol,gastroscopy can be performed effectively and safely.