异丙酚联合芬太尼在无痛胃镜麻醉中的应用

Application of fentanyl and propofol in painless gastroscopy

目的:探讨芬太尼和异丙酚在无痛胃镜中的麻醉镇痛效果和安全性.方法:将进行无痛胃镜检查的患者随机分为对照组和观察组各80例,对照组患者先经静脉注入芬太尼1g/kg,随后缓慢推注异丙酚2.5mg/kg;治疗组先静脉推注咪唑安定0.05mg/kg,再缓慢注入异丙酚2.5mg/kg,患者意识和睫毛反射消失后开始检查.比较两组的镇痛效果和检查前、中、后平均动脉压(mean arterial pressure,MAP)、静脉血氧饱和度(venous oxygen saturation,SPO2)和心率(heartrate,HR)的变化.结果:观察组麻醉镇痛效果的优良率为100%,明显高于对照组(Z=2.14,P=0.03)的92.5%,麻醉后两组患者术中的MAP、HR和SPO2与术前相比均有所下降,观察组术后恢复情况较好,其中HR和SPO2与对照组有极显著差异(P>0.01).结论:应用芬太尼和异丙酚进行无痛胃镜检查安全有效,可有效减轻患者痛苦.

AIM： To investigate the clinical efficacy and safety of use of propofol and fentanyl in painless gastroscopy. METHODS： One hundred and sixty patients who underwent painless gastroscopy were ran- domly and equally divided into either a control group or an observation group. The control group was intravenously injected with mid- azolam （0.05 mg/kg） and propofol （2.5 mg/kg）, while the observation group received fentanyl （1 txg/kg） and propofol （2.5 mg/kg）. Mean arte- rial pressure （MAP）, venous oxygen saturation （SPO2） and heart rate （HR） were compared be- tween the two groups. RESULTS： The rate of excellent analgesic ef- fect was higher in the observation group than in the control group （100% vs 92.5%, Z = 2.14, P = 0.03）. MAP, SPO2 and HR declined significantly after treatment in both groups compared to pre- treatment values （all P 〈 0.01）.CONCLUSION： Application of fentanyl and propofol in painless gastroscopy is safe and ef- fective and can alleviate the suffering of patients effectively.