预注瑞芬太尼对胃镜检查中丙泊酚注射痛和丙泊酚剂量的影响

Influence of remifentanil pre-injection on relieving propofol injection pain and dose of propofol during gastroscopy

目的探讨预注瑞芬太尼在减少胃镜检查时丙泊酚注射痛及丙泊酚剂量中的效果。方法行胃镜检查患者120例,随机分为对照组、观察1组、观察2组各40例。对照组静脉注射丙泊酚,观察1组、观察2组分别静脉注射0.2、0.3μg/kg瑞芬太尼30s后静脉注射丙泊酚,待患者睫毛反射消失后停止注射丙泊酚,插管行胃镜检查;检查过程中患者体动反应明显时追加丙泊酚0.3mg/kg。记录3组胃镜检查中应用丙泊酚总剂量及丙泊酚注射痛发生率,并进行比较。结果对照组胃镜检查中应用丙泊酚总剂量[(1.95±0.52)mg/kg]较观察1组[(1.45±0.31)mg/kg]、观察2组[(1.33±0.38)mg/kg]多,丙泊酚注射痛发生率(40.0%)较观察1组(12.5%)、观察2组(15.0%)高,差异均有统计学意义(P<0.05);观察1组、观察2组比较差异均无统计学意义(P>0.05)。结论胃镜检查前应用0.2μg/kg和0.3μg/kg瑞芬太尼均可降低丙泊酚注射痛发生率,减少胃镜检查中丙泊酚用量。

Objective To investigate the influence of remifentanil pre-injection on relieving propofol injection pain and dose of propofol during gastroscopy. Methods A total of 120 patients undergoing gastroscopy were randomly divided into control group, observation 1 group and observation 2 group, with 40 patients in each group. Control group received intravenous injection of propofol alone. Observation 1 and 2 groups received intravenous injection of propofol 30 seconds after intravenous injection of 0.2 and 0.3 μg/kg remifentanil respectively. Propofol was stopped injecting when lash reflex disappeared and endoscopic procedure began. When movement response became obvious, 0. 3 mg/kg propofol was injected additionally during endoscopic procedure. The total dose of propofol and the incidence of propofol injection pain were recorded and compared among three groups. Results The total dose of propofol was significantly higher in control group （（1.95± 0. 52） mg/kg） than that in observation 1 group （（1. 45± 0. 31） mg/kg） and observation 2 group （（1.33±0.38） mg/kg）, and the incidence of propofol injection pain was significantly higher in control group （40.0%） than that in observation 1 group （12.5%） and observation 2 group （15.0%） （P〈0.05）, and there was no significant difference between observation 1 and 2 groups （P〉0.05）. Conclusion The use of remifentanil at doses of 0. 2 and 0.3 μg/kg can reduce Both the incidence of propofol injection pain and the total dose of propofol during gastroscopy.