老年患者无痛胃肠镜检查麻醉药物使用分析

A retrospective analysis on use of narcotic drugs in aged patients with painless gastroscopy

目的评价老年患者无痛胃镜检查中麻醉药物使用的疗效和不良反应。方法分层随机选择2013年7月1日—2016年7月1日北京地区行胃镜检查的≥60岁老年患者1 800例,依据患者采用的麻醉用药分组:丙泊酚+舒芬太尼组(PS组)、依托咪酯+舒芬太尼组(ES组),比较2组患者心率、血压、血氧饱和度、麻醉效果、苏醒时间、呼吸抑制情况。结果调查对象平均年龄(68.5±9.4)岁,体重(58.3±15.7)kg,2组患者心率、血压、血氧饱和度、麻醉效果、苏醒时间、呼吸抑制情况差异均无统计学意义(均P>0.05),PS组低血压检出率高于ES组(χ~2=8.49,P=0.00)。结论老年患者行无痛胃镜术,丙泊酚复合舒芬太尼与依托咪酯复合舒芬太尼的麻醉效果均较好,但需预防患者出现低血压。

Objective To evaluate the effect and adverse effect of narcotic drugs in elderly people with painless gastroscopy. Methods One thousand eight hundred patients aged ≥ 60 years undergoing painless gastroscopy were selected by stratified random sampling from July 1,2013 to July 1,2016. According to the use of narcotic drugs ,the patients were divided into two groups as PS group （propofol ＋ sufentanil） and ES group （etomidate ＋ sufentanil）. The differences in heart rate, blood pressure, oxygen saturation, anesthetic effect, recovery time, and respiratory depression between the two groups were analyzed. Results The age of patients was 68.5±9. 4 years, and the weight was 58.3± 15.7 kg. There were no significant differences between the two groups in heart rate, blood pressure, oxygen saturation, anesthetic effect, recovery time, and respiratory depression （ all P 〉 0. 05 ）. The detection rate of hypotension in PS group was significantly higher than that of ES group （Xz = 8.49, P = 0. 004）. Conclusion Both propofol combined with sufentanil and etomidate combined with sufentanil were feasible and safe for aged patients with painless gastroscopy, but hypotension should be observed closely.