丙泊酚复合瑞米芬太尼用于门诊无痛胃镜检查的临床观察

Clinical observation on the application of combination of propofol-remifentani in painless gastroscopy

目的探讨丙泊酚复合瑞米芬太尼用于门诊无痛胃镜的安全性和有效性。方法ASAⅠ～Ⅱ级要求行门诊无痛胃镜检查的患者200例,随机分为2组,即丙泊酚瑞米芬太尼组(PR组)和丙泊酚组(P组),每组100例。P组以1.5～2.5mg/kg异丙酚推注,PR组以1～1.5mg/kg异丙酚推注,复合瑞芬太尼0.15μg/(kg.min)泵入,待其睫毛反射消失后开始进行胃镜检查。记录药物的总用药量、意识恢复和定向力恢复时间、术中呼吸抑制及体动等不良反应的发生率。结果两组患者术中的体动及呼吸抑制差异有统计学意义(P<0.05),且PR组丙泊酚用量明显少于P组,差异有统计学意义(P<0.05)。结论丙泊酚复合小剂量瑞米芬太尼不但可以减少丙泊酚用量,而且能有效降低呼吸抑制、体动等副反应。

Objective To evaluate efficacy and safety of combination of propofol-remifentani in painless gastroscopy. Methods 200 patients with grade of ASA Ⅰ-Ⅱ undergoing gastroscopy were divided randomly into group PR （ n = 100） and group P （ n = 100）. Patients in group P were infused propefol 1.5 - 2.5mg/kg intravenously; patients in group PR were infused propofoll - 1.5mg/kg intravenously and pumped remifentani 0.15μg/（ kg·min）. Gastroscopy was inserted after eyelashes reflex had been extinct. Total dose of propofol, recovering time of consciousness and orientation, and occurrence of body movement and respiratory depression were observed and recorded. Results There was significant difference in respiratory depression and body movement during operation between the two groups （P 〈 0.05）. The dosage of drug used in group P was obviously more than that in group PR（P 〈0, 05）. Conclusions The combination of propofol with remifentani applied to the operation of gastroscopy can provide satisfactory anesthesia effects with advantage of lower dose of propofol, less respiratory depression and less body movement.