芬太尼用于无痛胃镜检查优于等效剂量瑞芬太尼的临床研究

Fentanil is Better than Equivalent-dose Remifentanil Used in Painless Gastrospcopy

在无痛胃镜检查中观察并比较等效剂量瑞芬太尼和芬太尼血流动力学指标、氧饱和度的影响以及不良反应的发生率。择期无痛胃镜检查ASAⅠ级～Ⅱ级的患者90例，随机分为丙泊酚＋芬太尼组（PF组，n=40）和丙泊酚＋瑞芬太尼组（PR组，n=50），记录患者睫毛反射消失时间、胃镜操作时间、苏醒时间以及用药前（T1）、睫毛反射消失时（T2）、胃镜过咽喉部时（T3）、胃镜退出时（T4）、苏醒时（T5）等时点血流动力学指标和氧饱和度。结果两组患者较术前都有明显的血压下降，PR组窦性心动过缓20例（40．8%）、PF组8例（20．0％），PR组窦性心动过缓发生率明显增加（P〈0．05）。用于无痛胃镜检查麻醉时，瑞芬太尼不良反应较多，芬太尼相对更为安全。

To observe and compare the effects of remifentanil and fentanyl with equivalent-dose on the haemodynamics and blood oxygen saturation in patients undergoing painless gastroscopy. 90 patients （ASA Ⅰ～Ⅱ ） were randomly allocated into two groups. The patients receiving propofol and fentanyl （group PF,n=40） or propofol and remifentanil （group PR, n=50）, respectively. The periods of time of losing eyelash reflex, gastroscopy, and recovery time were observed. The parameter values of haemodynamics and blood oxygen saturation were recorded in the points of pre-administration （T1）, lost of eyelash reflex （T2）, gastroscopy pass through （T3） and withdraws （T4） laryngeal part of pharynx （T5）. Blood pressure declined obviously in both group after anesthesia. 20 patients （40.8%） in group PR and 8 patients （20.0%） in group PF experienced sinus bradycardia. The incidence of compared with that in group PF （P〈0.05）. In comparison, of adverse effect, fentanyl is the safer choice. sinus bradyeardia was significantly higher than group PR remifentanii used in painless gastroscopy has high occurrence .