瑞芬太尼效应室靶控输注在结肠镜检查中的应用

Application of remifentanil effect compartment target-controlled infusion in fibercolonscopy

目的比较复合丙泊酚静脉全麻时瑞芬太尼效应室靶控输注和芬太尼単次静脉注射用于结肠镜检查的麻醉效果。方法选择80例行结肠镜检查的患者,随机分为瑞芬太尼效应室靶控输注组(R组)和芬太尼单次静脉注射组(F组),分别复合丙泊酚静脉注射行静脉全麻,观察起效时间、恢复时间、准确定向时间、术中体动(程度和次数)、呼吸抑制以及术后并发症等。结果 R组恢复时间显著短于F组(P<0.01),R组的丙泊酚总用量、术中最低SpO_2、术中体动及术后恶心呕吐、嗜睡显著低于F组(P<0.01)。结论瑞芬太尼效应室靶控输注复合丙泊酚单次静脉注射的麻醉方法用于结肠镜检查,其临床效果优于芬太尼单次静脉注射复合丙泊酚的静脉麻醉,但需加强呼吸监护与管理。

Objective To compare the anesthesia effect between remifentanil effect compartment target-controlled infusion and single fentanyl intravenous injection in the fibereolonscopy during general anesthesia with propofol. Methods Eighty patients （ age range ： 18 - 70yr） undergoing fibercolonscopy were randomly divided into two groups：the patients in group R received remifentani] effect compartment target-controlled infusion and the patients in group F received single fentanyl intravenous injection, and the patients in both groups were performed with general anesthesia by propofol intravenous injection. The onset time： from start of propofol injection to no response to verbal command （T1） ,the recovery time ：from the end of injection to eye opening on verbal command （ T2）, exact directional time ： from eye opening to stating the question on request （ T3 ）, body movement during operation （including frequency and extent）, respiratory depression including HR, MBP and SpO2 and complications after operation were recorded for both groups. Results The recovery time （T2） in group R was significantly shorter than that in group F （ P 〈 0.01 ）. The total usage amount of propofol,the lowest SpO2, body movement during operation, the incidence of nausea, vomiting and lethargy after operation in group R were significantly less than those in group F （ P 〈 0.01 ）. Conclusion The clinical effect of remifentanil effect compartment target- controlled infusion combined with single propofol intravenous injection in fibercolonscopy is superior to that of single fentanyl intravenous injection combined with propofol intravenous anesthesia, however, the respiration custodial care and management should be enhanced.