舒芬太尼合用丙泊酚与单用丙泊酚用于无痛胃镜检查术的麻醉效果比较

Anesthesia Effect Comparison of Sufentanil Combined Propofol with Only Propofol Used in Painless Gastroscopy

目的观察舒芬太尼联合丙泊酚用于无痛纤维胃镜检查术的麻醉效果以及安全性。方法选择50例ASAⅠ-Ⅱ级行无痛纤维胃镜检查术患者,随机平均分为Ⅰ组（舒芬太尼＋丙泊酚）和Ⅱ组（单用丙泊酚）每组25例。Ⅰ组静脉滴注舒芬太尼5μg,2 min后静脉注射1.5 mg/kg丙泊酚;Ⅱ组单独静脉注射2.5 mg/kg丙泊酚;两组患者必要时每次追加丙泊酚0.2-0.3 mg/kg;比较两组麻醉镇痛效果与安全性;记录两组患者给药前（T0）、给药后2 min（T1）、过咽喉部（T2）和苏醒时（T3）HR、RR、SBP、Sp O2的变化;记录麻醉起效时间,苏醒时间和离院时间;麻醉后不良反应情况。结果Ⅰ组麻醉效果优于Ⅱ组（P〈0.05）T1时两组HR慢于、SBP及Sp O2均明显低于T0时（P〈0.05）。T1、T2、T3时Ⅱ组HR慢于、SBP低于Ⅰ组（P〈0.05）。Ⅱ组过咽喉部时呛咳明显高于Ⅰ组（P〈0.05）。Ⅱ组起效、苏醒、离院时间均长于Ⅰ组（P〈0.05）。Ⅱ组丙泊酚用量明显高于Ⅰ组（P〈0.05）。术中舌后坠、呼吸抑制Ⅱ组明显高于Ⅰ组（P〈0.05）,Ⅱ组苏醒时头晕发生率明显高于Ⅰ组（P〈0.05）。结论与单用丙泊酚相比,舒芬太尼联合丙泊酚可以更加安全舒适的用于无痛纤维胃镜检查术。

Objective To observe the anesthesia effect and safety of sufentanil and composite propofol used in painless fibergastroscopy. Methods We select 50 cases ASA Ⅰ - Ⅱ with painless fibergastroscopy,then divided them intoⅠgroups（ dealing with sufentanil and propofol） and Ⅱgroup（ dealing with propofol only）,25 cases in each group. InⅠ group,5 ugsufentanilis used in patients by intravenous drip,and after 2 minutes,1. 5 mg / kg propofol is used by intravenous injection; InⅡ group,only 2. 5 mg / kg propofol is used by intravenous injection. When necessary,add propofol 0. 2- 0. 3 mg / kg for patients of each group,then we compare two groups of narcotic analgesic effect and the security,and record the change of HR,RR,SBP,Sp O2 of two groups of patients before delivery T0,after 2 minutes T1,through throat T2 and at wake T3,also,we record the anesthesia effective time,wake up time and time of departure from the hospital,and the adverse reactions after anesthesia. Results Anesthesia effect inⅠ group is better than that of Ⅱgroup,HR of two groups patients is slower at T1（ P〈0. 05）,SBP and Sp O2 are significantly lower at T0（ P〈0. 05）. At T1,T2 and T3,HR of Ⅱgroup is slow,and SBP is l less than Ⅰgroup at（ P〈0. 05）. When through throat of Ⅱgrouppatients,choking cough is obviously higher than Ⅰgroup patients at（ P〈0. 05）. The effective time,waking time,departure from the hospital time ofⅡ group patients are longer than that ofⅠ group at（ P〈0. 05）. The dosage of propofol forⅡ group patients is obviously higher than that ofⅠ group at（ P〈0. 05）. During operation,tongue falling,breath depression inⅡ group patinets are significantly more than that inⅠ group patients at（ P〈0. 05）,also,when patients wake up,the incidence of dizziness inⅡ group is obviously higher than that in Ⅰgroup at（ P〈0. 05）. Conclusions Compared with the method of only using propofol,the sufentanil combined with propofol can be more safe and comfortable for treatment of painless fibergastroscopy.