咪唑安定复合雷米芬太尼在内镜黏膜下剥离术麻醉中的应用

Application of midazolam combined with remifentanil in patients undergoing endoscopic submucosal dissection

目的探讨咪唑安定复合雷米芬太尼在内镜黏膜下剥离术(ESD)的应用效果。方法拟行ESD手术患者60例,随机均分咪唑安定复合雷米芬太尼组(R组)和丙泊酚组(P组)。记录平均动脉压(MAP)、心率(HR)、手术时间、苏醒时间、术后不良反应等。给药前、停止给药后10 min进行数字符号匹配试验(DSST)评分。结果术中两组MAP、HR均稳定。首次剂量推注后,R组的呼吸频率、血氧饱和度低于P组。R组患者停止给药后10 min的DSST评分明显高于P组(P<0.01)。恢复期R组恶心呕吐发生率高于P组(P<0.05)。结论咪唑安定复合雷米芬太尼用于ESD手术的麻醉是安全有效的。

Objective To observe the outcomes of anaesthesia with midazolam combined with remifentanil infusion during endoscopic submucosal dissection（ESD）.Methods Sixty patients were randomly and equally assigned into two groups of R（remifentanil 0.5 μg/kg injection,followed by 0.05 μg·kg-1·min-1 infusion） and P（propofol 0.5 mg/kg injection,followed by 50 mg·kg-1·min-1 infusion）.Mean arterial pressure（MAP）,heart rate（HR）,operation time,recovery time and side effects were recorded.DSST score was evaluated before and at 10 minutes after stopping infusion.Results MAP and HR remained stable during operation in both groups.After bolus injection of the drugs,respiration rate and oxygen saturation were lower in group R than those in group P.The DSST score of group R was significantly higher than that in group P at 10 min after stopping infusion（P〈0.01）.The incidence of nausea and vomiting during the recovery from anesthesia was more in group R than that in group P（P〈0.05）.Conclusion Anesthesia with midazolam combined with remifentanil is safe and effective in the patients undergoing ESD.