阿芬太尼联合丙泊酚用于老年患者无痛胃肠镜检查的效果

Efficacy of alfentanil combined with propofol in elderly patients undergoing painless gastrointestinal endoscopy

目的观察阿芬太尼联合丙泊酚在老年患者行无痛胃肠镜检查的效果。方法将80例行无痛电子胃肠镜检查的老年患者随机均分为阿芬太尼联合丙泊酚组(F组)和丙泊酚组(D组)。观察两组患者给药前1min(T0)、胃镜进咽喉(T1)、胃镜活检(T2)、肠镜进肛门(T3)、过肝区(T4)、回盲部末端(T5)、检查结束(T6)时MAP、HR、RR、SpO_(2)和脑电双频指数(BIS)的变化,并记录丙泊酚用量、定向力恢复时间、苏醒时间和不良反应发生情况。结果F组T1和T2时的RR、SpO_(2)和BIS高于D组(P<0.05);F组T4和T5时的RR、SpO_(2)及T6时的MAP、RR、SpO_(2)均高于D组(P<0.05)。F组丙泊酚诱导剂量和总用药量、定向力恢复时间和苏醒时间少于D组(P<0.05)。F组呛咳、肠绞痛和恶心呕吐发生率低于D组(P<0.05)。结论在老年患者无痛胃肠镜检查中,联合应用阿芬太尼和丙泊酚可获得较好的镇静效果,减少丙泊酚用量,降低呼吸抑制、呛咳等不良反应发生率。

Objective To observe the efficacy of combined use of alfentanil and propofol in the elderly patients undergoing painless gastrointestinal endoscopy.Methods Eighty elderly patients undergoing painless gastrointestinal endoscopy were divided into two groups with 40cases each.Anesthesia was performed with alfentanil and propofol(group A)or with propofol alone(group B).The MAP,HR,RR,SpO_(2) and BIS were recorded at the time points of one minute before administration(T0),gastroscope insertion(T1)and endoscopic biopsy(T2),enteroscope insertion(T3),enteroscope passing through hepatic region(T4)and distal ileocecal region(T5),and at the end of the inspection(T6).The dosage of propofol,recovery time of orientation,awakening time,and incidence of adverse responses were recorded.Results The RR,SpO_(2)and BIS at T1and T2in group F were higher than those in group D(P<0.05).The RR and SpO_(2)at T4and T5and MAP,RR and SpO_(2)at T6in group F were higher than those in group D(P<0.05).The induction and total dosages of propofol,recovery time of orientation and awakening time in group F were less than those in group D(P<0.05).The incidences of choking cough,intestinal colic and nausea and vomiting in group F were lower than those in group D(P<0.05).Conclusion In the elderly patients undergoing painless gastrointestinal endoscopy,combined use of alfentanil and propofol may provide better sedative effect with reduced use of propofol and lower incidence of respiratory depression and choking cough.