芬太尼和瑞芬太尼复合异丙酚TCI给药对老年患者肠镜检查的比较

目的观察比较芬太尼和瑞芬太尼复合异丙酚TCI靶控输注在老年病人肠镜检查的效果。方法患者(60岁)100人,ASAI-II级。随机分为两组,芬太尼组(F组)和瑞芬太尼组(R组),F组静脉给予芬太尼0.05mg,R组瑞芬太尼负荷剂量0.5ug/kg,维持量为0.06ug/kg,而后连接TCI推注泵,推注泵设置:血浆靶控模式,血浆浓度2ug/ml。患者入睡后,置入肠镜,到达回盲部后,停止TCI给药。监测并记录麻醉过程中无创血压,血氧饱和度,心电图,呼吸,记录患者从苏醒至离院时间,术中呼吸抑制的人数,并对数据进行统计学分析。结果 F组和R组麻醉过程中无创血压,心率,呼吸较术前均有明显下降,但R组下降程度与F组相比有显著性差异(P0.05)。R组苏醒离院时间少于F组;R组术中呼吸人数大于F组。结论芬太尼和瑞芬太尼复合异丙酚TCI靶控输注均可安全用于老年人肠镜检查,瑞芬太尼组苏醒离院快,但术中呼吸抑制和血压下降高于芬太尼组。

The Comparison of Fentanyl and Remifentanil Combined with Propofol Target-Controlled Infusion Used in Painless Colonoscopy of Elderly patients

【Objective】Comparie the effectiveness of fentanyl and remifentanil combined with propofol target-controlled infusion Used in Painless Colonoscopy of Elderly patients.【Methods】100 ASAI-II level patients（over 60 years old） Were randomly divided into two groups,the fentanyl group（F group） and remifentanil group（R group）.F group fentanyl was given at a dose of 0.05mg,R group remifentanil was given at a loading dose of 0.5ug/kg,maintenance dose of 0.06ug/kg,then connect TCI injection pump.When colonoscopy reach the ileocecal valve stop the TCI injection pump.Monitoring and recording during anesthesia in non-invasive blood pressure,oxygen saturation,ECG,respiration.Records of patients discharged home from the wake up time,the patients number of respiratory depression,and the data were statistically analyzed.【Results】During anesthesia the non-invasive blood pressure,heart rate,respiration of F group and R group were significantly decreased compared with that before,but the decreased degree of R group compared with the F group was significantly different（P〈0.05）,The time of patients discharged home from the wake up were less than F group;the patients number of respiratory depression of R group were greater than F group.【Conclusions】Both fentanyl and remifentanil combined with propofol target-controlled infusion are safe for the elderly Patients accepting the painless colonoscopy.