依托咪酯复合小剂量舒芬太尼在小儿无痛全结肠镜检查中的应用

Appfication of etomidate combined with small dose sufentanil for painless colonoscopy in children patients

目的比较依托咪酯与丙泊酚均复合小剂量舒芬太尼在小儿无痛全结肠镜检查中的应用。方法将40例接受无痛全结肠镜检查的患儿完全随机分为研究组（依托咪酯＋小剂量舒芬太尼）及对照组（丙泊酚＋小剂量舒芬太尼），各组20例。监测并记录2组患儿诱导前、诱导后2、5和10min以及检查后各时点的平均动脉压、HR、血氧饱和度值；观察并记录全程不良反应及术后视觉模拟评分（VAS）法评分。结果对照组在诱导后2min平均动脉压明显下降，HR减慢，与诱导前比较差异均有统计学意义[平均动脉压：（65±6）mmHg（1mmHg：0．133kPa）比（81±6）mmHg，HR：（84±8）次／min比（111±13）次／min，P〈0．05]。研究组各时间点平均动脉压、HR及血氧饱和度比较稳定，与诱导前比较差异无统计学意义（P〉0．05）。2组患儿恶心呕吐及头晕等症状的发生率及术后VAS评分无明显差别。研究组的肌肉阵颤发生率略高于对照组，组间差异有统计学意义（P〈0．05）。结论依托咪酯复合小剂量舒芬太尼在小儿无痛全结肠镜检查中的应用安全有效，在心血管稳定性方面优于丙泊酚。

Objective To compare the application of etomidate and propofol with small doses sufentanil in children painless colonoseopy. Methods Forty patients receiving painless eolonoscopy were randomly divided into the study group （based on the etomidate with small doses sufentanil） and the control group （based on the propofol with small doses sufentanil）. The mean arterial pressure （MBP）, heart rate（ HR）, oxygen saturation values in the two groups were monitored and recorded at each time point such as before induction, after induction 2 min, 5 min, 10 min, after inspection. The whole adverse effects and postoperative visual analog scale （VAS） score were observed and recorded. Results In the control group, after induction 2 rain the MBP [ （65 ±6 ）mm Hg （ 1 mm Hg = 0. 133 kPa） ] and HR [ （ 84 ± 8 ） times/min ] were significantly less than those [ （ 81 ± 6 ） mm Hg, （111 ± 13）times/mini before induction （P 〈 0.05 ）. In the study group at each time point the MBP, HR and oxygen saturation values was relatively stable （ P 〉 0. 05 ）. There were no statistically significant on the incidence of nausea, vomiting and dizziness and other symptoms and the postoperative VAS score between two groups. In the study group the incidence of amyostasia was significantly higher than that in the control group （ P 〈 0. 05 ）. Conclusions Etomidate combined with small doses sufentanil in children painless colonoseopy is safe and effective, and superior to propofol in terms of cardiovascular stability.