催眠镇痛法无痛肠镜检查用于超高龄老年患者的安全性研究

The safety Of analgesia for colonoscopy with hypnosis and sedation in elderly patients

目的 探讨超高龄老年患者进行催眠镇痛法无痛肠镜检查的安全性.方法 选择165例大于80岁的超高龄老年患者（1组）,另择由同组医生检查的200例20～60岁的患者作为对照组（Ⅱ组）,采用咪达唑仑加屈他维林进行催眠镇痛法无痛肠镜检查,观察两组患者检查前、检查中、检查后血压、心率及血氧饱和度的变化,以及呼吸抑制和心律失常发生情况,同时记录咪达唑仑累计用药剂量及苏醒时间.结果 两组检查前、检查中、检查后心率、血压、血氧饱和度的差异无统计学意义（均P〉0.05）,Ⅰ组咪达唑仑用药剂量明显少于Ⅱ组（P〈0.05）,清醒时间明显延长（P〈0.05）;但Ⅰ组心律失常及呼吸抑制发生率与Ⅱ组相比无统计学差异（P〉0.05）.结论 咪达唑仑复合屈他维林用于超高龄老年患者的无痛肠镜检查安全可行,但要求严格根据个体情况及生命体征监测结果调整用药剂量.

Objective To investigate the safety of analgesia for colonoscopy with hypnosis and sedation in elderly patients. Methods One hundred and sixty-five elderly patients aged over 80y （ Group Ⅰ） and another 200 patients aged 20-60y （Group Ⅱ） underwent colonoscopic examinations; combination of midazolam and drotaverine was administrated in both groups. Blood pressure （BP）, heart rate （HR）, oxygen saturation （SpO2）, occurrence of respiratory depression and arrhythmia before, during and after procedures were monitored; and the accumulated dosage of midazolam and the recovery time were recorded. Results There were no statistical differences in BP, HR, SpO2 before, during and after colonoscopy; and in the occurrence of respiratory depression and arrhythmia between two groups. Compared with Group Ⅱ, the patients in Group Ⅰ took less midazolam, and had a prolonged recovery time. Conclusion Analgesia for colonoscopy with midazolam and drotaverine is effective and safe for elderly patients.