丙泊酚联合芬太尼麻醉在治疗性内镜逆行胰胆管造影术中的应用

Application of propofol combined with fentanly in therapeutic ERCP

目的观察丙泊酚联合芬太尼在治疗性内镜逆行胰胆管造影术(ERCP)检查中的应用效果及安全性。方法选286例ASAⅠ～Ⅲ择期行治疗性ERCP的患者分成丙泊酚麻醉组(P组),丙泊酚联合芬太尼麻醉组(PF组),每组143例。记录每组患者术前、术中、术后的平均动脉压(MAP)、心率(HR)、血氧饱和度(SPO2)、丙泊酚用量及手术持续时间、术毕患者的苏醒时间、麻醉期间的不良反应如舌后坠、肢体扭动及呼吸抑制等。结果 P组术中MAP、HR变化与术前、PF组比较差异有显著性(P<0.05),PF组苏醒、离院时间及丙泊酚用量小于P组(P<0.05)。结论丙泊酚联合芬太尼在治疗性ERCP中应用是安全有效的,值得推广。

[Objective] Endosccopic retrograde cholangiopangiopancreatography（ERCP） is the most complex gastrointestional procedure, which is intolerable in certain portion of patients. The aim of this study was to investigate the quality and safety of propofol combined with fentanly in therapeutic ERCP. [Methods] Two hundred sixty-four patients with ASAⅠ～Ⅲ underwent therapeutic ERCP were randomly assigned into two groups（n =132 each）, patients underwent propofol sedation or propofol combined with fentanly sedation. The parameter, such as MAP, HR, SPO2, the dose of propofol , the recovery time, discharged time were observed and recorded. [Results] The changes of NBP, HR, SPO2 were less than the base line in group P during operation （P 0.05）, and the recovery time, discharged time and the dose of propofol in group PF were less than that in group P （P 0.05）. [Conclusions] Propofol combined with fentanly provides safe and effective sedation in therapeutic ERCP, which can be widely used.