老年无痛胃镜检查中地佐辛和瑞芬太尼的比较分析

Comparative analysis of dezocine and remifentanil in senile patients with painless gastroscopy

目的探讨老年无痛胃镜检查中地佐辛和瑞芬太尼麻醉效果的比较。方法 80例无痛胃镜检查老年患者,随机分为地佐辛组(D组)和瑞芬太尼组(R组),每组40例。D组患者静脉注射地佐辛和丙泊酚;R组患者静脉注射瑞芬太尼和丙泊酚。观察两组患者术中心率(HR)、呼吸频率(RR)、平均动脉压(MAP)以及血氧饱和度(SpO_2)变化,比较两组苏醒时Ramsay镇静(RSS)评分以及呼吸抑制、恶心呕吐、体动等不良反应。结果两组患者HR在麻醉诱导后(T2)时较麻醉诱导前(T1)时显著下降(P<0.05);两组患者T2时HR比较差异无统计学意义(P>0.05)。T2时两组RR比较差异无统计学意义(P>0.05)。T2时两组患者的MAP、SpO_2较T1时均明显下降(P<0.05),但T2时D组患者的MAP、SpO_2较R组下降缓和,差异有统计学意义(P<0.05)。D组患者出体动例数1例明显少于R组的7例,差异有统计学意义(P<0.05);D组患者苏醒时RSS评分为(2.5±0.3)分,低于R组的(3.7±0.7)分(P<0.05)。结论与瑞芬太尼复合丙泊酚相比,地佐辛复合丙泊酚在老年人无痛胃镜检查中麻醉效果确切,血流动力稳定,苏醒时清醒程度高,不良反应少,可以安全用于临床。

Objective To investigate the anesthesia effect of dezocine and remifentanil in examinationof painless gastroscopy.Methods A total of80senile patients with painless gastroscopy were randomly dividedinto dezocine group(group D)and remifentanil group(group R),with40cases in each group.Group D receivedintravenous injection of dezocine and propofol,and group R received intravenous injection of remifentanil andpropofol.Observation were made on intraoperative heart rate(HR),respiratory rate(RR),mean arterial pressure(MAP),and oxygen saturation(SpO2)changes in two groups,and comparison were made on Ramsay sedation score(RSS)during recovery,adverse reactions of respiratory depression,nausea,vomiting,and body motion in twogroups.Results Both groups had obviously declined HR after anesthesia induction(T2)than before anesthesiainduction(T1)(P<0.05).Both groups had no statistically significant difference in HR at T2(P>0.05).Both groupshad no statistically significant difference in RR at T2(P>0.05).Both groups had obviously decreased and relievedMAP and SpO2at T2than at T1(P<0.05).At T2,group D had lower MAP and SpO2than group R,and theirdifference was statistically significant(P<0.05).Group D had obviously less number of body motions as1case than7cases in group R,and the difference was statistically significant(P<0.05).Group D had lower RSS during recoveryas(2.5±0.3)points than(3.7±0.7)points in group R(P<0.05).Conclusion Compared with remifentanil combinedwith propofol,dezocine combining with propofol shows affirmative anesthesia effect in senile patients with painlessgastroscopy,with stable hemodynamics,high degree of sobriety during recovery and fewer adverse reactions.It canbe safely applied in clinic.