无痛肠镜麻醉中不同给药方法对呼吸和循环的影响

Effects of propofol titration anesthesia on respiration and circulation of patents during painless colonoscopy

目的:比较丙泊酚滴定麻醉和传统麻醉方法用于无痛肠镜时呼吸和循环的变化,寻找对呼吸循环影响小的给药方法;评估不同滴定诱导终点在无痛肠镜麻醉中的差别。方法:拟行无痛肠镜检查患者90例,随机分为3组,MOAA/S评分达1分为诱导终点组(M组)、睫毛反射消失为诱导终点组(E组)及对照组(C组),每组30例。记录各组呼吸抑制、低血压的发生例数和苏醒时间。记录不同时点的平均血压、心率和脉搏氧饱和度。结果:和C组相比,M组和E组呼吸抑制和低血压的发生例数少(P<0.05),苏醒时间短(P<0.05)。M组和E组并发症发生率及血流动力学改变无显著差异(P>0.05)。结论:相比传统用药方法,丙泊酚滴定麻醉用于肠镜检查可减少对呼吸和循环的影响,苏醒迅速。以MOAA/S达到1分或睫毛反射消失为诱导终点对呼吸和循环的影响无显著差别。

AIM： To compare the effects of propofol titration anesthesia with the traditional administration on respiration and circulation in the patients undergoing painless colonoscopy. METHODS： Ninety patients, who were going to undergo elective painless colonoscopy with ASA physical status Ⅰ-Ⅱ and aged 18 - 60 years, were randomly divided into 3 groups （30 patients each）. In group M, it was used as the induction end point that MOAA/S scale reached 1, while the disappearance of eyelash reflex was used for the patients in group E. In control group （ C）, induction was performed only based on the body weight （2 mg·kg- 1 ）. The cases of respiration depression and hypotension were recorded. The recovery time was also observed. Mean blood pressure, heart rate and pulse oxygen saturation were monitored at different time points. RESULTS： Compared with group C, the cases of respiratory depression and hypotension were less and shorter recovery time was achieved in group M and group E （P 〈 0.05）. No difference of the incidence in respiration depression, hypoten- sion, and the hemodynamic changes between group M and group E was observed. CONCLUSION： Propofol titration anes- thesia for painless colonoscopy can diminish the disturbance of respiration and circulation, leading to rapid recovery. Use of the patient＇ s vanishing of the eyelash reflex or gaining MOAA/S score 1 as the induction end point is reasonable.