靶控输注丙泊酚复合芬太尼静脉麻醉在结肠镜检查中的应用

A clinical study of the target-controlled infusion of propofol combined with fentanyl in intravenous anesthesia under colonoscopy

目的观察靶控输注丙泊酚复合芬太尼静脉麻醉在结肠镜诊治中的效果和安全性。方法将120例需要结肠镜检查的患者随机分成麻醉组与对照组,每组各60例,观察2组检查前、中、后血压、心率和氧饱和度变化,比较结肠镜操作效果及不良反应。结果麻醉组60例患者均4级镇静状态下完成操作,到达回盲部成功率为100%,到达回盲部时间为(8.6±4.6)min,对照组达回盲部时间为(16.1±3.3)min(P<0.05);麻醉组37例患者无需变动体位即到达回盲部,而对照组有3例(P<0.05)。麻醉组检查前、中、后血压、心率、氧饱和度比较均无明显变化(P>0.05);对照组均有不同程度的疼痛,评分>6分的25例。检查中与检查前后比较,血压升高、心率变快(P<0.05),氧饱和度比较无差异(P>0.05)。结论靶控输注丙泊酚复合芬太尼静脉麻醉下的结肠镜诊治,安全有效,操作便利,时间缩短,不良反应低。

Objective To observe the safety and efficacy of target-controlled infusion of propofol combined with fentanyl in intravenous anesthesia under colonoscopy.Methods 60 patients in sedative group were given target-controlled infusion of fentanyl combined with propofol,60 patients in control group were not used any anesthesia.Blood pressure,heart rate,blood oxygen saturation,operative time,and adverse reaction were compared.Results 60 patients in sedative group were completed successfully when they were in the 4 grade anesthesia state.The time of colonoscope reaching ileocecal valve was 8.6 ±4.6min.In control group the time was 16.1 ±3.3min.There was significant difference in the two groups（P0.05）;In sedative group,37 patients needn＇t move their body when colonoscope reached ileocecal valve.But in control group there were only 3 cases.There was significant difference in the two groups（P 0.05）.There was no significant difference in blood pressure,heart rate,blood oxygen saturation during the procedure of examination.60 patients in control group were completed successfully,but all patients felt pain.The pain score was over 6 in 25 case.Compared with before and after colonoscope,blood pressure,heart rate increased during colonoscope（P 0.05）.There was no significant difference in blood oxygen saturation（P0.05）.Conclusion It is safe and effective to perform colonoscope with target-controlled infusion of fentanyl combined with propofol.The operation is convenient,the time is short,and the adverse reactions is much lower than that of traditional methods.