丙泊酚配伍芬太尼在无痛肠镜中的应用

Application of Combination Propofol and Fentanyl on Painless Enteroscopy

目的探讨丙泊酚配伍芬太尼应用于无痛肠镜手术的最佳给药方案。方法 120例患者随机分为3组,实施丙泊酚芬太尼复合静脉麻醉。A组为丙泊酚配伍0.5μg/kg芬太尼,B组为丙泊酚配伍1.0μg/kg芬太尼,C组为丙泊酚配伍1.5μg/kg芬太尼。术中详细记录各组丙泊酚用量以及各项观察指标。结果丙泊酚配伍芬太尼给药后,随着芬太尼剂量的逐步加大,丙泊酚的剂量逐步下降,二者存在剂量负相关效应。芬太尼剂量为0.5μg/kg时,丙泊酚剂量为3.89 mg/kg,镇痛镇静效果一般,并且存在吸和循环抑制。芬太尼剂量为1.0μg/kg时,丙泊酚的剂量为2.47 mg/kg,该组患者的镇痛和镇静效果俱佳,无1例发生呼吸抑制现象。芬太尼剂量达1.5μg/kg时,丙泊酚剂量为1.53 mg/kg,虽然镇痛效果最佳,但是丙泊酚引发的呼吸和循环抑制得到增强。结论 2.5 mg/kg丙泊酚联合1.0μg/kg芬太尼给药方案应用于无痛肠镜手术的麻醉,麻醉效果确切,值得临床推广和普及。

Objective To investigate the optimized anaesthesia scheme of applying the propofol and fentanyl to the painless enteroseopy. Methods 120 patients were divided into three groups at random to be performed with anaesthesia of combination of propofol and fentanyl. Patients in group A were administered with combination of propofol and 0. 5 μg/kg fentanyl, patients in group B were administered with combination of propofol and 1.0 μg/kg fentanyl, and patients in group C were administered with combination of propofol and 1.5 μg/kg fentanyl. The propofol dose level for each group was recorded, as well as the necessary monitored parameters. Results Propofol＇s dose was gradually declined with the increase of fentanyl＇s dose, which indicated that there was a dose -related interaction between propofol and fentanyl. When combined with 0. 5 μg/kg fentanyl, propofol＇s dose was 3.89 mg/kg, which did not reach expected analgesic and sedative effects, and respiratory and circulatory depression were observed. When combined with 1.0 μg/kg fentanyl, propofol＇s dose was 2. 47 mg/kg, and expected analgesic and sedative effects were obtained without any respiratory and circulatory depression. When combined with 1.5 μg/kg fentanyl, propofol＇s dose was 1.53 mg/kg, and expected analgesic and sedative effects were obtained, but respiratory and circulatory triggered by propofol were observed concurrently. Conclusions Combination of 2. 5 mg/kg propofol and 1.0 μg/kg fentanyl could be the optimized anaesthesia scheme to be used in painless enteroscopy.