异丙酚复合瑞芬太尼静脉麻醉在老年ERCP检查中的应用

Application of Intravenous Anesthesia with Remifentanil /Propofol in Gerontal Patient Undergoing Endoscopic Retrograde Cholangio Pancreatography

目的探讨瑞芬太尼复合异丙酚用于老年内镜逆行胰胆管造影术(ERCP)的麻醉效果及安全性。方法58例需行ERCP的老年患者,随机分成异丙酚组和异丙酚瑞芬太尼复合组,观察2组麻醉中各时间段(诱导前后、进镜前后、术毕)的收缩压、舒张压、呼吸频率、脉搏血氧饱和度,不良反应(呃逆、流涎、咳嗽、体动)以及清醒时间和手术时间。结果两组患者诱导前后收缩压差异显著(P<0.01),组间比较,复合组收缩压、呼吸频率在诱导后、进镜前后、术毕时点明显低于单用组(P<0.05);两组患者平均手术时间、平均清醒时间、不良反应发生率有明显差异(P<0.05)。结论瑞芬太尼复合异丙酚能有效维持ERCP术中的血流动力学稳定,术后不良反应较少,容易苏醒,对老年患者为安全的麻醉选择方式。

Objective To approach the anaesthesia efficacy and safety of remifentanil combined with propofol in old patients undergoing endoscopic retrograde cholangio pancreatography（ ER- CP）. Methods Fifty- eight patients undergoing ERCP were evenly divided at random into two groups： propofol group and remifentanil combined with propofol group. Systolic blood pressure （SBP）, diastolic blood pressure （DBP）, breathing frequency （BR）, saturation of blood oxygen, adverse effect, consciousness time, operation time were observed before and after anesthesia induction and insert endoscope, and at the end of operation. Results There were significant differences between two groups in SBP after anesthesia induction （P 〈 0. O1 ）. Group comparison, SBP and BR of remifentanil combined with propofol group after anesthesia induction, before and after insert endoscope, and at the end of operation were lower than that of propofol group（P 〈0.05）. There were significant differences between two groups in average operation time, average consciousness time, adverse effect incidence （P 〈 0. 05）. Conclusion Remifentanil combined with propofol could maintain haemodynamics stability during ERCP and cause less adverse reaction. It is a safe anesthesia selective mode to gerontal patient.