地佐辛和芬太尼分别联合丙泊酚用于无痛肠镜麻醉的临床观察

Clinical observation of dezocine and fentanyl respectively combined with propofol in painless colonoscopy anesthesia

目的对地佐辛和芬太尼分别联合丙泊酚用于无痛肠镜麻醉的效果进行分析。方法将我院2014年1月～2015年1月收治的92例纤维结肠镜检查患者随机分为对照组和观察组，对照组46例患者以芬太尼联合丙泊酚麻醉，观察组46例患者以地佐辛联合丙泊酚麻醉，对比两组患者手术前后的HR、SpO2、RR、MAP、意识消失时间、苏醒时间、视觉模拟评分、丙泊酚用量及患者的满意度。结果观察组患者术后5min的SBP及HR明显高于对照组，差异有统计学意义（P〈0．05）。其余时间段的指标差异无统计学意义（P〉0．05）。观察组患者的术后可唤醒时间及留观时间明显短于对照组，差异有统计学意义（P〈0．05）。两组患者的丙泊酚用量差异无统计学意义（P〉0．05）。观察组的不良反应发生率明显低于对照组，差异有统计学意义（P〈0．05）。观察组的麻醉满意度为93．48％，对照组的麻醉满意度为80．43％，观察组的满意度明显高于对照组，差异有统计学意义（P〈0．05）。结论对无痛肠镜患者采用地佐辛联合丙泊酚麻醉具有镇静及镇痛效果理想、安全性高等优点，值得临床推广借鉴。

Objective To analyze and discuss the effects of Dezocine and fentanyl respectively combined with propofol for painless colonoscopy anesthesia. Methods 92 cases of patients with fiber colonoscopy in our hospital from January 2014 to January 2015 were randomly divided into the control group and the observation group. The 46 patients in the control group accepted fentanyl combined with propofol anesthesia, and the 46 patients in the observation group ac- cepted Dezocine combined with propofol anesthesia. HR, SpO2, RR, MAP, unconsciousness time, recovery time, visual analogue scale, propofol dosage and patient satisfaction of patients in the two groups before and after surgery were compared. Results The SBP and HR of patients in the observation group 5 minutes after surgery were significantly higher than those in the control group, and the differences were statistically significant （P〈0.05）. Indicators in the rest periods were not significantly different（P〉0.05）. Postoperative waking up time and observing time of patients in the ob- servation group were significantly shorter than those in the control group, and the differences were statistically signifi- cant （P〈0.05）. Propofol dosage of the two groups was not statistically significant （P〉O.05）. Adverse reaction rate of the observation group was significantly lower than that in the control group, and the difference was statistically significant （P〈0.05）. Anesthesia satisfaction of the observation group was 93.48%, and that of the control group was 80.43%. Anes- thesia satisfaction of the observation group was significantly higher than that of the control group, and the difference was statistically significant （P〈0.05）. Conclusion Dezocine combined with propofol for painless colonoscopy anesthesia has advantages of sedation and analgesia, and good security, etc. It is worthy of clinical promotion and reference.