瑞芬太尼与舒芬太尼在无痛内镜检查中的效果比较

Comparison of Remifentanil and Sufentanil in Painless Endoscopy Results

目的观察瑞芬太尼、舒芬太尼和芬太尼应用于无痛内镜检查的镇静镇痛效果比较。方法选择我院内镜室2012年9月至10月收治的无痛内镜检查患者90例,随机分为瑞芬太尼组、舒芬太尼组和芬太尼组各30例。观察三组患者术中血压、心率、血氧饱和度、睫毛反射消失时间,瑞芬太尼、舒芬太尼和芬太尼、异丙酚的使用情况,阿托品和麻黄素的使用情况。结果对三组患者麻醉过程进行比较,瑞芬太尼组和舒芬太尼组的睫毛反射消失时间短,肢体运动发生率低,血压和心率明显降低,心动过缓和呼吸抑制的发生率则增高,瑞芬太尼组和舒芬太尼组对呼唤睁眼时间、定向力恢复时间、离院时间明显短于芬太尼组,两组与芬太尼组比较差异有显著性(P<0.05),瑞芬太尼组和舒芬太尼组比较差异无显著性(P>0.05)。结论无痛内镜检查中使用丙泊酚复合瑞芬太尼和舒芬太尼,术中疼痛少,术毕恢复快等优点,呕吐、烦躁等不良反应少,是安全有效的方法。

Objective To compare the effects of sedation and analgesia with remifentanil, sufentanil and fentanyl used in painless endoscopy. Methods 90 patients with painless endoscopy September to October treated in our hospital from 2012 cases endoscopy room, were randomLy divided into remifentanil group, sufentanil group and fentanyl group with 30 cases in each. Observation of three groups of patients with blood pressure, heart rate, oxygen saturation, eyelash reflex time, the use of remifentanil, sufentanil and fentanyl, propofol, usage of atropine and ephedrine. Result To compare the three groups of patients during anesthesia, sufentanil and remifentanil groups group of eyelash reflex time is short, low incidence of limb movement, blood pressure and heart rate decreased significantly, heartbeat bradycardia and respiratory inhibition is increased, sufentanil and remifentanil groups of call time to eye opening, orientation recovery time, leave hospital time obviously shorter than in the fentanyl group, there was significant difference between the two group and fentanyl group （P〈0.05）, remifentanil group and sufentanil group had no significant difference （P〉0.05）, Conclusion The use of propofol and remifentanil and sufentanil in painless endoscopy, less pain during the operation, postoperative convalescence, vomiting, irritability and other adverse reactions, is a safe and effective method.