丙泊酚复合不同阿片类药物在老年人结肠镜检查中的镇静效果

Effect of propofol combined with different opioids on sedation during colonoscopy in the elderly

目的探讨丙泊酚复合不同阿片类药物应用于老年人结肠镜检查镇静的效果。方法60例老年结肠镜受检者随机分为3组，均采用靶控输注方法给予丙泊酚，其中20例单次推注芬太尼（芬太尼组），靶控输注舒芬太尼（舒芬太尼组）、瑞芬太尼（瑞芬太尼组）各20例。记录患者血流动力学改变、镇静深度和不良事件。结果3组受检患者一般情况、血流动力学改变、镇静深度和不良事件比较差异无统计学意义（均P〉O．05）。检查后恢复时间芬太尼组[（21．3±4．6）min]长于舒芬太尼组[（19．9±3．3）min]和瑞芬太尼组[（15．9±1．8）min]，且与瑞芬太尼组比较差异有统计学意义（均P〈O．05）。结论丙泊酚复合3种阿片类药物均可安全有效地用于老年人结肠镜检查，但使用瑞芬太尼受检者恢复更为迅速。

Objective To explore the feasibility and safety of fentanyl, sufentanil or remifentanil combined with target-controlled infusion （TCI） of propofol for sedation in the elderly undergoing colonoscopy. Methods In this prospective randomized study, 60 patients undergoing colonoscopy and propofol TCI were randomly assigned to group F （fentanyl）, group S （sufentanil） and group R （remifentanil）（each n= 20）. Patients in group F received a single bolus of fentanyl, while those in group S and group R received TCI sufentanil and remifentanil separately. The blood pressure, heart rate, blood oxygen content and Bispectral index （BIS） were monitored, and all the complications were recorded. Results All patients were adequately sedated. There were no significant differences in general conditions, hemodynamics changes, sedation depth and adverse event among the three groups （all P：〉0.05）. Time for recovery was longer in group F [（21.3±4.6） min] than in group S [（19. 9±3. 3） min] and group R[（15.9±1.8） min, P〈0.05]. Conclusions For the elderly undergoing colonoscopy, sedation with fentanyl, sufentanil or remifentanil combined with propofol TCI is feasible and safe. It is more excellent for the remifentanil group at shorter discharge time.