依托咪酯脂肪乳剂与丙泊酚在无痛胃镜中的应用

Application of etomidate fat emulsion and propofol for painless gastroscopy

目的:探讨依托咪酯脂肪乳剂(剂量之比7:1)或丙泊酚分别复合芬太尼在无痛胃镜的安全性和有效性。方法:2013年3-8月收治行无痛胃镜患者120例,随机分为依托咪酯脂肪乳剂组(A组)和丙泊酚组(B组),分别复合芬太尼静脉麻醉,观察患者HR、SPO2、MAP,药物起效时间,手术时间,患者苏醒时间,肌阵挛例数,恶心呕吐例数。对两组结果使用统计学方法进行分析。结果:依托咪酯脂肪乳组与丙泊酚组患者药物起效时间、手术时间和苏醒时间无明显差别,术中肌阵挛依托咪酯脂肪乳剂组(A组)18例,丙泊酚组(B组)1例,术后恶心、呕吐依托咪酯脂肪乳剂组(A组)7例,丙泊酚组(B组)2例,B组MAP、HR均低于术前值(P<0.05)。结论:依托咪酯脂肪乳与丙泊酚复合芬太尼均能用于胃镜检查,并取得满意效果。丙泊酚心血管抑制作用较依托咪酯强,而肌阵挛发生率以及术后恶心呕吐发生率丙泊酚均较依托咪酯少。

Objective:To explore the safety and efficacy of etomidate fat emulsion(dose ratio 7:1) or propofol combined with fentanyl in painless gastroscopy.Methods:120 cases with painless gastroscopy were selected from March to August 2013.They were randomly divided into the etomidate fat emulsion group(group A) and the propofol group(B group).They were anesthetized respectively combined with fentanyl.We observed the HR,SPO2,MAP,drug onset time,operation time,recovery time of patients,the number of cases with myoclonus,the number of cases of nausea and vomiting of the two groups.We compared the efficacy of the two groups.Results:There was no significant difference in drug onset time,operation time and recovery time of the two groups.During the operation,etomidate fat emulsion group(A group) had myoclonus in 18 cases;the propofol group(B group) was 1 case.After the operation,etomidate fat emulsion group(A group) had 7 cases of nausea,vomiting;the propofol group(B group) was 2 cases.In group B,MAP,HR were lower than that before operation(P<0.05).Conclusion:Etomidate fat emulsion or propofol combined with fentanyl can be used for gastroscopy,and achieve satisfactory results.The cardiovascular inhibition of propofol is stronger than etomidate myoclonus,and the postoperative incidence of nausea and vomiting is lower than etomidate.