丙泊酚复合咪唑安定加枸橼酸舒芬太尼用于无痛胃镜检查的临床观察

Clinical Observation of Propofol Combined with Midazolam and Sufentanil Citrate for Painless Gastroscopy

目的观察丙泊酚复合咪唑安定加枸橼酸舒芬太尼用于无痛胃镜检查的效果。方法选取美国麻醉医师协会(ASA)分级为1～2级的需作胃镜检查及治疗的患者200例,随机均分为两组,Ⅰ组静脉注射枸橼酸舒芬太尼0.1μg/kg,1～2min后缓慢静脉滴注丙泊酚1～2mg/kg;Ⅱ组静脉注射咪唑安定1mg,枸橼酸舒芬太尼0.1μg/kg,1～2min后缓慢静脉滴注丙泊酚1～2mg/kg。待患者意识消失时开始行胃镜检查及治疗,根据肢体活动度及手术时间决定是否追加丙泊酚,直到胃镜检查及治疗结束。结果Ⅱ组中94例达到完全无痛,6例因做胃镜治疗时间超过10min出现肢体活动,追加丙泊酚20～40mg后安静;除1例患者术中发生呼吸抑制,经托起下颌、面罩加压给氧后很快缓解,术中血压、心率有轻度波动,其余患者生命体征平稳。Ⅱ组效果明显优于Ⅰ组。结论丙泊酚复合咪唑安定加枸橼酸舒芬太尼用于无痛胃镜检查及治疗,是一种较安全有效的理想麻醉方法。

Objective To investigate the application of propofol combined with midazolam and sulfentanyl for painless gastroscopy. Methods 200 patients with ASA grading 1- 2 requiring gastroscopic examination and treatment were enrolled. Firstly, the patients were administrated sufentanyl 0. 1 μg/kg by intravenous drip, then midazolam 1 mg after 1- 2 min, at last slowly administrated propofol 1- 2 mg/kg. When patients lost consciousness, doctors began to conduct gastroscopy and treatment. According to the body activity and operation time, whether to add propofol 20- 40mg or not, until the end of the examination and treatment. Results Among 200 cases, 94 cases were completely painless, 6 cases had body moving due to the treatment time more than 10 min, but became quiet after giving additional propofol. One case developed intraoperative respiratory depression and recovered soon by holding up his jaw and pressurized oxygen mask with slight fluctuations of blood pressure and heart rate. The remaining patients were stable in vital signs. Conclusion Propofol combined with midazolam and sulfentanyl for painless gastroscopy is a safe and effective anesthesia method.