两种药物分别复合丙泊酚静脉麻醉用于纤维结肠镜检查的麻醉效果及安全性比较

Clinical investigation of anesthesia efficacy and safety between two drugs joint propofol intravenous anesthe-sia respectively for colonoscopy

目的：探讨氯胺酮和芬太尼与丙泊酚复合静脉麻醉用于纤维结肠镜检查麻醉效果及安全性，为临床诊治提供参考。方法选择行纤维结肠镜检查患者120例，按照数字表法随机分为对照组与观察组，各60例。对照组检查前使用氯胺酮联合丙泊酚麻醉，观察组检查前使用芬太尼与丙泊酚复合静脉麻醉，比较两组动脉压（MAP）、心率（HR）、脉搏血氧饱和度（SpO2），并比较两组苏醒时间、离院时间、麻醉效果以及不良反应。结果观察组麻醉优良率为86．67％，与对照组的85．00％差异无统计学意义（χ2＝0．984，P ＝0．114）；观察组苏醒时间及离院时间分别为（7．44±177;1．24）min、（19．11±177;2．67）min，明显短于对照组，差异均有统计学意义（t ＝5．847，P ＝0．004；t ＝6．922，P ＝0．001）；观察组与对照组 MAP、SpO2、HR 各时间点三项指标差异均无统计学意义（均 P ＞0．05）；观察组不良反应发生率为21．67％，对照组为36．67％，两组差异有统计学意义（χ2＝5．665，P ＝0．007）。结论芬太尼与丙泊酚复合静脉麻醉用于纤维结肠镜检查麻醉效果及安全性佳，值得临床推广应用。

Objective To investigate anesthesia efficacy and safety between two drugs joint propofol intrave-nous anesthesia for colonoscopy,to provide reference for clinical treatment.Methods 120 routine colonoscopy patients were selected,they were randomly divided into control group and observation group,60 cases in each group. Patients of the control group were given ketamine and propofol before examination.Patients in the observation group were given fentanyl and propofol for intravenous anesthesia before the examination.The arterial pressure MAP,heart rate,HR,pulse oximetry SpO2 ,recovery time,time away from the hospital,anesthetic effects and adverse reactions were compared between the two groups.Results Anesthesia excellent rate in the observation group was 86.67%,that was 85.00% in the control group,the difference was not significant （χ2 =0.984,P =0.114）.In the observation group,the recovery time and time away from the hospital were （7.44 ±177;1.24）min,（19.11 ±177;2.67）min,which were significantly shorter than those in the control group,the differences were statistically significant （t =5.847,P =0.004;t =6.922,P =0.001）.The MAP,SpO2,HR at different time points showed statistically significant differences between the two groups（P ＆gt;0.05）.The incidence rate of adverse reactions in the observation group was 21.67%, that in the control group was 36.67%,the difference was not statistically significant （χ2 =5.665,P =0.007）. Conclusion Fentanyl and propofol for intravenous anesthesia in colonoscopy has good anesthetic effect and good safety,which is worthy of clinical application.