小剂量丙泊酚联合输注咪达唑仑、氟哌利多和芬太尼在胃镜检查中的镇静镇痛效果观察

目的了解小剂量丙泊酚联合输注咪达唑仑、氟哌利多和芬太尼在胃镜检查中的镇静镇痛效果。方法选择2012年1月至2013年6月在廊坊市第四人民医院接受无痛胃镜检查的患者186例,按入院时间顺序编号,奇数入四药物组,偶数入两药物组,每组93例。四药物组静脉注射咪达唑仑1.5 mg,氟哌利多1 mg,芬太尼0.075 mg,丙泊酚20 mg;两药物组静脉注射芬太尼0.05 mg后缓慢推注丙泊酚1.5 mg/kg。所有患者呈浅睡状态后开始置入胃镜,检查过程中根据患者反应追加芬太尼0.05 mg或丙泊酚10²0 mg。记录丙泊酚应用总量、清醒时间和离院时间,观测检查过程中患者的血压(SBP)、心率(HR)、血氧饱和度和不良反应。结果两组间手术前后血压、心率、血氧饱和度比较差异无统计学意义(P>0.05);四药物组与两药物组比较,丙泊酚用量(33.9±16.9)mg vs(93.3±20.3)mg]、清醒时间(1.5±0.9)min vs(5.3±3.3)min]、离院时间(21.5±5.1)min vs(24.1±3.8)min]和不良反应发生率(14例vs 56例)少于两药物组(P<0.05)。结论小剂量丙泊酚联合输注咪达唑仑、氟哌利多和芬太尼在胃镜检查中的镇静镇痛作用,效果确切,不良反应少。

Sedation and Analgesia Effect of Small dose of Propofol Combined with Midazolam,Droperidol and Fentanyl in Gastroseopy

Objective To understand the sedation analgesia effect of small dose of propofol combined with midazolam, droperidol and fentanyl in gastroseopy. Methods A total of 186 patients who received painless gastroseopy between Jan. 2012 and Jun. 2013 in Langfang City Fourth People＇s Hospital were numbered according to the sequence of admittance to the hospital and divided into odd number group to receive a treatment of four drugs, and even number group to receive a treatment of two drugs, 93 cases in each group. Patients in four drugs group received midazolam 1.5 mg,droperidol l mg,fentanyl 0. 075 rag and propofo120 mg through intravenous injection; two drugs group：fentanyl 0.05 mg and propofol 1.5 mg/kg. All patients began with gastroscopy after falling into sleep state, additional fentanyl 0.05 mg or propofol 10-20 mg were given during the procedure according to the patients response. Application amount of propofol, waking time and time of departure from the hospital were recorded,blood pressure（BP） and heart rate（HR） ,blood oxygen saturation（ SPO2 ） and adverse reactions in the process of examination were observed. Results There were no statistical differences in BP, HR and SPO2 between the two groups（ P 〉 0.05 ） ;four drugs group vs two drugs group：dosage of propofol （33.9 ± 16.9） rag vs （93.3 ±20.3） mg] ,waking hours （1.5 ±0.9） min vs （5.3 ±3.3） mini ,time of departure from the hospital （21.5 ±5.1 ） rain vs （24.1 ±3.8） mini ,and the incidence of adverse reaction （ 14 cases vs 56 cases）the data of the fourdrugs group were all less than those in two drugs group（P 〈 0.05 ）. Conclusion Sedation and analgesia effect of small dose of propofol com bined with midazolam, droperidol and fentanyl in gastroscopy has been proved to be exact with less side effects.