异丙酚联合舒芬太尼喷鼻用于无痛胃镜检查的初步观察

目的探讨舒芬太尼鼻腔给药辅助异丙酚无痛胃镜检查麻醉的临床效果。方法采用前瞻、双盲、随机对照研究方法,选择80例ASAⅠ～Ⅱ级的胃镜检查患者,随机分为对照组(鼻腔喷入生理盐水+异丙酚)和观察组(鼻腔喷入舒芬太尼+异丙酚),记录各时间点HR、SBP、DBP、SpO2及异丙酚用量、检查时间、苏醒时间和不良反应等。结果两组总体麻醉效果相似,均能够满足胃镜检查需要;舒芬太尼喷鼻2 min后近半数患者出现头晕,其发生率显著高于对照组(P<0.01);对照组异丙酚用量(180.15±0.55)mg,明显多于观察组(158.65±0.31)mg(P<0.05);注射异丙酚后两组均出现循环抑制,与对照组比较,观察组的心血管抑制作用更强,持续时间更长;两组的体动反应、注射痛、呛咳、舌后坠及术中知晓的发生率相似,差异无统计学意义(P>0.05)。结论舒芬太尼喷鼻使用,起效迅速,可引起头晕症状。在胃镜检查麻醉中,预先小剂量舒芬太尼喷鼻,可以减少异丙酚用量,但未能改善麻醉效果,却明显增强和延长循环抑制。

Preliminary observation of propofol combined with sufentanil nasal spray for the painless gastroscopy

Objective To observe the clinical effect of sufentanil nasal spray in propofol anesthesia for the painless gastroscopy.Methods Eighty patients,ASA Ⅰ～Ⅱ,scheduled for painless gastroscopy under propofol anesthesia were included and randomly divided into control group and observation group.Before injection of propofol,patients received normal saline nasal spray in control group or sufentanil nasal spray in observation group.The check time,recovery time,adverse reaction,propofol consumption and the changes of HR,SBP,DBP,SpO2 and so on were recorded and analysed.Results The anesthesia effects of the two groups were similar and able to meet the needs for gastroscopy.At 2 min after sufentanil nasal spray,dizziness incidence rate in observer group(47.50%) was significantly higher than that in control group(P < 0.01).Per capita consumption of propofol in the control group was(180.15±0.55)mg,it was significantly larger than(158.65±0.31)mg the observation group(P < 0.05).After propofol injection,all patients appeared circulatory depression significantly.The observation group’s cardiovascular inhibitory is stronger and longer than the control group’s.There were no statistically significant differences in the incidence of body movement,injection pain,cough reflex,glossocoma and intraoperative awareness between the two groups.Conclusion Sufentanil nasal spray can cause dizziness with rapid onset.Preemptive sufentanil nasal spray can significantly reduce the consumption of propofol,enhance and prolong circulation inhibition,but fail to significantly improve the anesthetic effect.