丙泊酚和依托咪酯分别联合舒芬太尼应用于内镜下息肉摘除术120例麻醉效果评价

Evaluation of anesthesia effects of propofol or etomidate combined with sufentanil on 120 cases of endoscopic polypectomy

目的 :比较丙泊酚和依托咪酯分别联合舒芬太尼应用于内镜下息肉摘除术的麻醉效果及不良反应。方法 :选取我院内镜下息肉摘除术患者120例,ASA I-II级,随机分为丙泊酚联合舒芬太尼组(A组)60例,依托咪酯联合舒芬太尼组(B组)60例,监测并记录手术前、中、后的血流动力学变化;记录麻醉前(T0)、给药后入镜前(T1)、入镜后2 min(T2)、入镜后5 min(T3)、检查结束(T4)、苏醒时(T5)的心率,平均动脉压、血氧饱和度以及苏醒时间、不良事件以及术后并发症的发生率。结果 :A组在T1、T2、T3、T4时HR、MAP下降明显(P<0.05)。B组的HR、MAP在各时间点比较差异无统计学意义(P>0.05)。结论 :内镜下息肉摘除术术前用依托咪酯联合舒芬太尼麻醉,对血压、心率影响小,不良反应发生少,安全性高,推荐临床使用。

Objective： To compare the effects of propofol or etomidate combined with sufentanil on endoscopic polypectomy and their adverse reactions. Methods： One hundred and twenty patients with endoscopic polypectomy were randomly divided into group A（propofol combined with sufentanil anesthesia） and B（etomidate combined with sufentanil anesthesia） with 60 cases each. The hemodynamic changes before, during and after surgery and HR, MAP and Sp O2 before anesthesia（T0）, before entry after administration（T1）, 2 and 5 minutes after entry（T2 and T3）, at the end of examination（Y4） and the wake-up（T5） were recorded and the time for wake-up, adverse events and the incidence of complications were compared. Results： The HR and MAP at T1, T2, T3 and T4 were significantly decreased in group A compared with group B（P〈0.05） while the comparison of HR and MAP at every time point in group B showed no statistical significance（P〉0.05）. Conclusion： Preoperative application of anesthesia of etomidate combined with sufentanil in endoscopic polypectomy has less effects on blood pressure and heart rate and less incidence of adverse reactions with high safety and can be recommended for clinical use.