异丙酚、芬太尼、东莨菪碱复合麻醉在消化内镜中的应用效果观察

The efficacy of intraveneous propofol combined with fentanyl and scopolamine in gastrointestinal endoscopy

目的 研究异丙酚、芬太尼、东莨菪碱复合麻醉在消化内镜中的临床效果及安全性。方法 拟行消化内镜检查及治疗病人 1 5 0例 ,随机分为三组即 :A组 (局麻组 ) 5 0例 ,B组 (对照组 ) 5 0例 ,C组 (实验组 ) 5 0例。行胃镜检查病人用 1 %地卡因喷喉。A组表面麻醉下进行操作 ;B组先给以 0 0 0 1mg·kg-1 芬太尼静脉注射 ,然后将 0 8mg·kg-1 异丙酚用微泵按 3 2～ 4 8mg·kg-1 ·min-1 静脉注射 ,再以 3～ 8mg·kg-1 ·h-1 速度异丙酚静脉注射维持麻醉 ,直至睫毛反射消失后 ,开始检查工作 ,待内镜进入检查部位时停止麻醉 ,若术中麻醉深度不满足检查要求时再以每次 0 4mg·kg-1 异丙酚静脉注射以维持麻醉 ;C组先给以0 0 0 1mg·kg-1 芬太尼、0 0 0 6mg·kg-1 东莨菪碱混合液静脉注射后 ,其余同B组。全部病人分别在麻醉前及麻醉后 1min、3min、6min、9min、1 2min、手术结束进行监测HR、R、BP、SpO2 、ECG以及麻醉效果评定。结果 在所有的监测项目结果中A组与B、C组间比较统计学有极显著差异 (P <0 0 1 ) ;B、C组间异丙酚用量、检查时间、麻醉效果比较统计学有极显著差异 (P <0 0 1 ) ,B、C组间DBP、SpO2 比较差异有显著意义 (P <0 0 5 ) ,检查开始后SpO2 比较有极显著差异 (P <0 0 1 )。结论 异?

Objective To study the safety and efficacy under gastrointestinal endoscopy with intraveneous propofol combined with fentanyl and scopolamine Methods 150 patients who were performed gastrointestinal endoscopy were randomly divided into 3 groups(n=50,respectively) Patients were throat sprinkling using 1% Dicarine before gastroscopy group A,the local anesthesia group,were performed with traditional methods;group B,the control group,with intraveneous fentanyl 0 001 mg kg -1 at first,and then intravenous propofol 0 8 mg kg -1 ,at the speed of 3 2 to 4 8 mg kg -1 min,and keep patients under anesthesia with intravenous propofol 0 4 mg kg -1 ,waiting until patients eyelash reflex disappears,then start the endoscope performation,and stop anesthesia when endoscope reached the location of examination;group C,the experimental group,with intraveneous the mixture of fentanyl 0 001 mg kg -1 and scopolamine 0 006 mg kg -1 at first,and then follow as procedure of group B The changes of heart rate,respiratory,blood pressure,and blood oxygen saturation and ECG were recorded and analysed before anesthesia and at the time of 1 min,3min,6 min,9 min,12 min during anesthesia as well as at the end of endoscopy,efficacy of anesthesia was also evaluated Results There was significant difference in statistic in all the observation index in compared with group A,group B and groupC(P<0 01);there was significant difference of the dosage of propofol,time of examination and efficacy of anesthesia,as well as blood pressure,SpO 2,in compared with group B and group C(P<0 01,P<0 05,respectively) Conclusion It was safe and effective to perform gastrointestinal endoscope with intraveneous propofol combined with fentanyl and scopolamine