丙泊酚、芬太尼复合小剂量咪达唑仑在食管静脉曲张套扎术中的疗效与安全性分析

Efficacy and Safety of Combined Administration of Propofol,Fentanyl and Low-dose of Midazolam in Endoscopic Variceal Ligation

目的：探讨丙泊酚、芬太尼复合小剂量咪唑安定静脉麻醉在食管静脉曲张套扎术（EVL）中的疗效与安全性。方法：将68例要求进行EVL的肝硬化患者根据麻醉药物组合及剂量不同随机分为两组,Ⅰ组（丙泊酚、芬太尼复合小剂量咪唑安定组）和Ⅱ组（丙泊酚复合芬太尼组）。Ⅰ组给予咪唑安定0.02mg/kg、芬太尼0.5μg/kg、丙泊酚1~1.5mg/kg;Ⅱ组给予芬太尼0.5μg/kg,丙泊酚1.5~2.5mg/kg。记录两组患者的心率、血压、呼吸、血氧饱和度。比较两组患者麻醉药用量、麻醉起效时间、麻醉苏醒时间情况以及术中术后不良反应情况。结果：两组患者在应用静脉麻醉药物后收缩压及舒张压术中与术前比较有明显下降（P〈0.01）,但为一过性,术后恢复至术前水平。Ⅰ组患者的HR、Sp O2、R术中与术前比较差异均无统计学意义（P〉0.05）;Ⅱ组患者术中的HR、SPO2、R与术前比较差异有统计学意义（P〈0.05）。Ⅰ组在麻醉药用量少于Ⅱ组（P〈0.05）,麻醉起效时间上两组间无明显差异,麻醉苏醒时间上Ⅰ组短于Ⅱ组（P〈0.05）。麻醉不良反应两组均有出现,差异无统计学意义（P〉0.05）;两组间满意度调查结果均为100%。结论：丙泊酚、芬太尼复合小剂量咪达唑仑能更安全有效地用于肝硬化患者EVL。

Objective： To evaluate the efficacy and safety of combined administration of propofol,fentanyl and low-dose of midazolam for intravenous anesthesia in patients with esophageal varices.Methods：Sixty-eight patients with liver cirrhosis scheduled for EVL were randomly divided into group Ⅰ and group Ⅱ according to the drug combination and dosage.Group Ⅰ were injected with midazolam 0.02mg/kg,fentanyl 0.5μg/kg and propofol l-l.Smg/kg.Group Ⅱ were given fentanyl 0.5μg/kg and propofol 1.5-2.5mg/ kg.The heart rate,blood pressure,respiration and blood oxygen saturation were monitored.The anesthetic dosage,the onset time,the recovery time and the adverse reaction of the two groups were compared.Results：The systolic blood pressure and diastolic blood pressure of the two intravenous anesthesia groups decreased in the operation when compared with that measured before the operation.However,this is a transient phenomenon,i.e.,all these values measured after the operation changed to the same as that before the operation.There was no differences （P〉0.05） between intraoperative and preoperative in the aspect of the heart rate,respiration and blood oxygen saturation of group Ⅰ ; but the differences of all these values of group Ⅱ was statically significant（P〈0.05）.The anesthetic dosage of group Ⅰ was less than that of group Ⅱ （P〈0.05）.The onset time of two groups had no differences.The recovery time of groupⅠ was shorter than that of group Ⅱ （P〈0.05）.The adverse reaction happened in the two groups,hut there was no differences（P〉0.05）.The satisfaction survey of the two groups were 100%.Conclusion：Combined administration of propofol,fentanyl and low-dose of midazolam is more safety and efficacy in the treatment of patients with liver cirrhosis scheduled for EVL.