两种镇痛方法用于无痛结肠镜检查的临床分析

Clinical Analysis of Two Kinds of Analgesia Methods in the Painless Colonoscopy

目的观察丙泊酚配伍小剂量舒芬太尼静脉麻醉和低浓度可调笑氧混合气体吸入两种镇痛方法在无痛结肠镜检查中的临床效果,旨在寻找一种更方便、安全、舒适的检查方法。方法 2010年5月~2010年12月在我院自愿接受无痛结肠镜检查的163例患者按自愿原则分为两组,对其生命体征（血压、血氧饱和度、心率）的变化及镇痛效果进行观察分析。结果检查中静脉麻醉组出现血压下降,心率减慢现象,与麻醉前比较存在显著性差异（P〈0.05）,血氧饱和度在低流量吸氧的情况下与麻醉前比较无统计学差异（P〉0.05）：低浓度可调笑氧混合气体吸入组生命体征（心率、血氧饱和度）的变化有统计学差异（P〈0.05）;笑气吸入组生命体征与静脉麻醉组相比较有统计学差异（P〈0.05）;静脉麻醉组镇痛效果明显高于笑气吸入组。结论在麻醉及内镜医师的配合下的丙泊酚配伍小剂量舒芬太尼静脉麻醉完全无痛,虽在检查中出现血压及心率一过性的下降,但均在正常范围,舒适安全,值得推广。低浓度可凋笑氧混合气体吸入无需专业麻醉师及监护仪器,生命体征变化平稳,镇痛效果略差,但价格低廉,适合在基层医院推广。

Objective To observe clinical effect propofol compatibility small doses of sufentanil intravenous anesthesia and adjustable low-concentration of mixed oxygen and nitrous oxide inhalation tow kinds of analgesia methods in the painless colonoscopy,to find a kind of more convenient,safer and confortable method.Methods ln our hospital from May 2010 to December 2010,163 patients accepted the painless colonoscopy by the principle of voluntariness were divide into tow groups and to observe and analysis variation of vital signs（blood pressure,blood oxygen saturation,heart rate）and the effect of analgesia.Results During the inspection,the group of intravenous anesthesia appear fall of blood pressure and slow heart,which have signilicant diffenrrences in statistics compare with anesthesia before（P0.05）,blood oxygen saturation under the condition of low flow oxygen have no diffenrrences compare with anesthesia before（P0.05）.The inhaled group have significant diffenrrences in statistics on the varlalion of vital signs（blood oxygen saturation,heart rate）（P0.05）.The inhaled group have significant diffenrrences in statistics on the variation of vital signs compare with the group of intravenous anesthesia（P0.05）.The effect of analgesia of intravenous anesthesia obviously higher than the nitrous oxide inhalation.Conclusion Under the anesthesiologists in cooperation with endoscopic physicians,the group of intravenous anesthesia is completely painless.Although during the inspection,blood pressure and heart rate have a transient drop,but they are all in the normal range.The inhaled group have no professional anestbetis and monitoring instrument,the vital signs vary smoothly.Although the effect of analgesia is slightly less,but the price is low and suitable for basic-level hospitals.