异丙酚和瑞芬太尼联合应用于无痛胃镜的可行性

The different third phenol and Swiss Fentaini apply jointly in the indolence gastrascope＇s feasibility

随着门诊短小手术和检查的日渐增多，麻醉科医师在门诊的作用也目渐突出。门诊短小手术或检查的麻醉，以其病例多且集中，要求术后清醒迅速，完全为其特点。目前，在国内，麻醉科医师参与的门诊短小手术，主要是无痛人流手术和门诊的无痛胃镜和肠镜检查等。虽然这些操作相对风险较小，但是痛苦十分明显，麻醉科医师的介入为病人带来福音，同时为检查创造了条件，很快就取得了令大家都满意的效果。然而，随着要求无痛人流，无痛胃镜和肠镜的患者越来越多，就需要开发更为短效的，更为安全的麻醉方案。只有如此，才能更好地满足患者的需求。目前，较为理想的静脉短效麻醉药是瑞芬太尼和异丙酚。单纯使用异丙酚麻醉虽然迅速、苏醒快，但对病人的循环抑制明显，特别在用量超过2mg／kg，对呼吸和循环的影响非常明显，是我们进行非气管插管全身麻醉非常不安全的因素。瑞芬太尼具有起效迅速，作用时间短，停止输注后血药浓度下降速度与异丙酚相当，代谢不受肝肾功能影响等优点，可能非常适合与并丙酚联合用于无痛胃镜的检查。本研究的目的：探讨不气管插管或喉罩，不使用微量输注泵或靶控输注和不使用口服局麻药的条件下，把异丙酚和瑞芬太尼联合应用于无痛胃镜的可行性。

Along with the outpatient service short surgery and inspection day after day increase, anesthesiology department doctor also day after day highlights in the outpatient service function. The outpatient service short surgery or the inspection anaesthesi a, by its case are many, and concentrates, after requesting the technique, sober rapid, completely for its characteristic. At present, in domestic, anesthesiology department doctor participation the outpatient service short surgery, is mainly the indolence stream of people surgery and the outpatient service indolence gastroscope and the intestines mirror inspection and so on. Although these operation relative risk is small, but the pain is very obvious, the anesthesiology department doctor＇s involvement brings the gospel for the patient, simultaneously has created the condition for the inspection, has made very quickly the progress which makes everybody to satisfy. However, along with the request indolence stream of people, the indolence gastroscope and the intestines mirror＇s patient are getting more and more, needs to develop a shorter effect, safer anaesthesia plan. Only then so, can meet patient＇s need well. At present, the more ideal vein short effect anaesthetic is Swiss Fentaini and the different third phenol. Uses the different third phenol anaesthesia purely, although rapid, regains consciousness quickly, but suppresses obviously to patient＇s circulation, surpasses 2mg/kg specially in the amount used, to breathes is obvious with the circulation influence, is we carry on the non--trachea cannula general anesthesia very unsafe factor. Swiss Fentaini has the effect to be rapid, the response time is short, after stopping the infusion, the blood medicine density rate of descent and the different third phenol quite, metabolism merits and so on hepatorenal function influence, possibly is not been suitable and the different third phenol uses in jointly the indolence gastroscope＇s inspection, this research goal： The discussion not trachea cannula either the throat cover, does not use the micro infusion pump or the target controls the infusion and does not use the oral administration bureau anesthetic under the condition, applies jointly the different third phenol and Swiss Fentaini in the indolence gastroscope＇s feasibility.