66例肝硬化患者行内镜下食道静脉曲张套扎术麻醉方法研究

Clinical study of anesthesia during endoscopic variceal ligation

目的探讨丙泊酚、芬太尼及复合小剂量咪唑安定用于内镜下食管静脉曲张套扎术(EVL)麻醉效果及安全性。方法将66例要求进行EVL的肝硬化患者随机分为两组,PFM组(丙泊酚、芬太尼复合小剂量咪唑安定组)和PF组(丙泊酚复合芬太尼组)。在手术过程中连续监测平均动脉压(MAR)、心率(HR)和脉搏血氧饱和度(SpO2)。同时记录起效时间、恢复时间、不良反应及丙泊酚用量。结果所有患者均未出现严重低血压、心动过缓及低氧血症等。亦未发生大出血、明显体动、不适、严重恶心、呕吐等不良反应。结论丙泊酚复合芬太尼及丙泊酚、芬太尼复合小剂量咪唑安定用于EVL均安全有效,值得临床推广应用。

Objective To explore the effects and safety of anesthesia with propofol combined with fentanyl and little dose of mi- dazolam or propofol combined with fentanyl during endoscopic variceal ligation （EVL）. Methods Sixty-six patients with liver eir- rohsis undergoing EVL were randomized to receive either propofol combined with fentanyl and little dose of midazolam （group PFM, n=33） or propofot combined with fentanyl （group PF n = 33） for anesthesia during operation. MAP, HR and SPO2 were mo nitored during anesthesia and operation. The time required for loss of eyelash reflex, and for post anesthetic consciousness recovery, adverse effects and the total amount of propofol consumed were recorded. Results No severe hypotension, bradycardia, hypoxia, hemorrhage,body movement,nausea or vomiting were observed in either group. Conclusion Anesthesia during EVL with either propofol-fentanyl-little dose of midazolam or propofol-fentanyl is safe and effective and recommended for clinical use.