不同剂量阿芬太尼复合丙泊酚用于无痛胃镜检查的效果

目的 观察不同剂量阿芬太尼复合丙泊酚用于无痛胃镜的效果,探讨阿芬太尼复合丙泊酚用于无痛胃镜时的最佳剂量.方法 选择2020年11月至2021年1月行无痛胃镜检查患者200例,男87例,女113例,年龄18～60岁,BMI 18～28 kg/m2,ASAⅠ或Ⅱ级.采用随机数字表法将患者分为四组:阿芬太尼3μg/kg组(A...

Effects of different doses of alfentanil combined with propofol on painless gastroscopy

Objective To observe the efficacy and safety of alfentanil combined with propofol in painless gastroscopy,and to explore the optimal dose of alfentanil when combined with propofol in painless gastroscopy.Methods A total of 200 patients,87 males and 113 females,aged 18-60 years,BMI 18-28 kg/m²,ASA physical statusⅠorⅡ,who underwent painless gastroscopy from November 2020 to January 2021 were randomly divided into 4 groups:alfentanil 3μg/kg group(group A3),alfentanil 5μg/kg group(group A5),alfentanil 7μg/kg group(group A7)and alfentanil 9μg/kg group(group A9),50 patients in each group.The four groups were given alfentanil 3,5,7,9μg/kg intravenously 3 minutes after oxygen inhalation,respectively,and propofol 2 mg/kg intravenously 1 minute after injection.Modified observer s assessment of alertness and sedation(MOAA/S)scale was performed immediately after administration,and evaluated every 30 seconds until the MOAA/S≤3 scores.If the endoscopy failed or the MOAA/S score≥4 scores 2 minutes after injection,propofol was added for 0.5 mg/kg until MOAA/S≤3 scores,and the interval between each additional drug was more than 1 minute.The success cases of induction of first administration,induction time of anesthesia,operation time,recovery time and standard time of dicharge were recorded.SBP,DBP,HR,SpO₂ and RR were recorded 1 minute before injection(T₁),at the time of MOAA/S≤3 scores(T₂),at the beginning of operation(T₃),1 minute after the beginning(T₄)and at the end of operation(T₅).The additional cases of propofol,patient satisfaction,surgeon satisfaction and anesthesiologist satisfaction,the occurrence of injection pain and intraoperative adverse events(body reaction,respiratory depression and hypotension)were recorded.Results Compared with T₁,SBP and DBP in the four groups were significantly decreased at T₂-T₅(P<0.05),RR in group A3 increased significantly at T₂ and decreased significantly at T₅(P<0.05).Compared with group A3,the induction time of anesthesia in groups A5,A7,and A9 was significantly shorter,the success rate of first induction,the satisfaction rate of patients and surgeons were significantly higher,the additional cases of propofol,the incidence of body reaction and injection pain were significantly decreased(P<0.05).Compared with group A3,the standard hospital stay in groups A5 and A7 was significantly shortened,and the satisfaction rate of anesthesiologists was significantly increased(P<0.05).Compared with group A3,the recovery time and the incidence of respiratory depression in group A9 was significantly increased(P<0.05).Compared with group A5,the additional cases of propofol was significantly decreased in groups A7 and A9(P<0.05);the recovery time,the standard time to discharge and the incidence of respiratory depression were significantly increased,and the satisfaction rate of anesthesiologists was significantly decreased in group A9(P<0.05).Compared with group A7,the recovery time,the standard hospital stay and the incidence of respiratory depression in group A9 were significantly increased,and the satisfaction rate of anesthesiologists was significantly decreased(P<0.05).Conclusion Alfentanil combined with propofol for painless gastroscopy is safe,effective and feasible.Afentanil 7μg/kg combined with propofol has good sedative and analgesic effect with less propofol dosage and adverse reactions.