丙泊酚效应室靶控输注用于患心血管疾病老年人胃镜结肠镜联合检查的临床观察

目的 观察效应室靶控（TCI）丙泊酚用于患心血管疾病老年患者胃肠镜检查的效果和安全性.方法 合并一种以上心血管疾病的拟行择期胃镜＋结肠镜检查的患者40例（年龄60-80岁）,分为TCI组和TIVA组（n=20）,分别以效应室浓度2.5 μg/ml靶控输注和1-1.5 mg/kg初始量＋5 mg/kg/h恒速输注丙泊酚.记录术中循环情况,苏醒时间,并发症,丙泊酚用量和患者满意度.结果 两组患者均顺利完成检查,TCI组术中循环波动幅度小,用药量少,术中体动、低氧等并发症少,两组患者在苏醒时间上无差异,而均未出现术后恶心呕吐和术中知晓.TCI组的苏醒时效应室浓度为0.96±0.23μg/ml.结论 Ce=2.5 μg/ml的效应室靶控模式输注丙泊酚用于合并心血管疾病老年患者胃镜＋肠镜联合检查麻醉效果确切,维持剂量少,安全有效.

A prospective study of effect-site concentration propofol target-controlled infusion during gastrointestinal endoscopy in elderly patients with cardiovascular complications

Objective This study aimed to evaluate the effects and safety of propofol effect-site concentration Target-Controlled in elderly patients with cardiovascular complications.Methods A total of 40 patients undergoing diagnostic gastrointestinal endoscopy were recruited for this study.Patients were randomly assigned to 2 groups （n=20）.TIVA patients received the same regimen to induce conscious sedation,including a bolus of propofol （1-1.5 mg/kg） and continued with 0.5 mg/kg/h infusion..The TCI patients received propofol which was calculated using the Schneider model with effect-site concentration of 2.5 μg/ml.The hemodynamic parameters,time to consciousness recovery,propofol consumption and side-effects were recorded.Results The hemodynamic changes,the requirement of propofol and the incidences of hypoxemia and unconscious movement were lower in TCI group.The time to consciousness recovery and the post-procedure satisfaction rate was no differences in both groups.There was no intraoperative awareness and postoperative nausea and vomiting was found in all patients.The Ce ROC （concentration of consciousness recovery） was 0.96±0.23 μg/ml in TCI group.Conclusion A low Ce of propofol TCI 2.5 μg/mL achieved adequate anesthesia,reduced the risk of hypotension,and attained a high satisfaction rate in elderly population with cardiovascular complications undergoing diagnostic painless gastrointestinal endoscopy.