不同剂量舒芬太尼用于高龄患者胃镜检查清醒镇静的临床研究

Clinical study on the dosage of sufentanil in conscious sedation for elderly patients undergoing gastroscopy

目的探索高龄患者胃肠镜检查清醒镇静的最适舒芬太尼剂量。方法选取拟进行无痛胃肠镜检查的高龄患者120例,随机分为三组,分别给予低剂量舒芬太尼(咪唑安定0.027 mg/kg,0.15 g/kg,低剂量组)、中剂量舒芬太尼(咪唑安定0.027 mg/kg,0.20 g/kg,中剂量组)和高剂量舒芬太尼(咪唑安定0.027 mg/kg,0.25 g/kg,高剂量组),每组40例。记录并比较各组患者的镇静评分和低氧血症及严重呼吸暂停事件发生率。结果低、中剂量组镇静评分明显低于高剂量组,并且呼吸频率变化、低氧血症、严重呼吸暂停发生情况明显低于高剂量组,差异有显著性(P<0.05)。结论老年患者进行清醒镇静下无痛胃肠镜检查,推荐的镇静用药剂量为咪唑安定0.027 mg/kg,舒芬太尼0.15~0.20μg/kg。

Objective To explore the anesthetic process and dosage of conscious sedation in elderly patients with gastrointestinal endoscopy.Methods A total of 120 elderly patients underwent painless gastrointestinal endoscopy,they were randomly divided into three groups,patients in low dosage group were given with low dosage of sufentanil and midazolam（ 0. 027 mg / kg and 0. 15 g / kg respectively）,patients in median dosage group with sufentanil and midazolam（ 0. 027 mg / kg and 0. 20 g / kg respectively） and high dosage group with sufentanil and midazolam（ 0. 027 mg / kg and0. 25 g / kg respectively）,and 40 cases in each group. The scores of sedation,rate of hypoxemia and severe apnea were compared among patients in these 3 groups. Results In median and low dosage groups（ midazolam 0. 027 mg / kg and sufentanil 0. 15 - 0. 20 μg / kg）,the sedation scores in performance were obviously higher than those of low dosage group,and changes in respiration rate,hypoxemia and occurrence of severe respiratory pause were significantly lower than those of high dosage group. Conclusion The recommended dosages for conscious sedation in elderly patients for painless gastrointestinal endoscopy are midazolam 0. 027 mg / kg and sufentanil 0. 15 - 0. 20 μg / kg.