胃肠镜检查术中应用异丙酚麻醉临床效果观察

目的: 观察胃肠镜检查术中异丙酚iv麻醉的效果及安全性. 方法: 将658例接受胃肠镜检查的患者随机分为异丙酚组(P组,228例,单纯iv异丙酚1～1.5 mg/kg麻醉)、给予利多卡因及麻黄碱后再行异丙酚iv麻醉组(LEP组,200例,给予利多卡因20 mg及麻黄碱6 mg后行异丙酚iv麻醉)、常规组(C组,230例,常规操作). 记录3组检查前、中及检查结束后5 min的心率(HR)、血压(SBP/DBP)、脉搏血氧饱和度(SpO2)、操作时间、是否完成检查、患者的苏醒时间、满意度及不良反应. 结果: P组和C组检查中血压,心率变化最大时比检查前降低或升高20.0%～30.0%和10.0%～30.0%. LEP组变化较小,血压仅降低3.0%,心率增加7.0%,与P,C组相比具有统计学差异(P<0.05). P组患者主诉有血管刺激症状185例,占81.1%,而LE组患者仅28例,占14.0%,具有统计学差异(P<0.05). 结论: 在胃肠镜检查时应用异丙酚iv可达到满意的麻醉效果. 麻醉前给予小剂量利多卡因及麻黄碱可明显减弱异丙酚的心血管反应.

Clinical observation on the anesthetic effect of propofol during gastrointestinal endoscopy

AIM: To observe the anesthetic effect and safety of propofol during gastrointestinal endoscopy.METHODS: Six hundred and fifty-eight cases receiving gastrointestinal endoscopy were enrolled in this prospective study and were randomized into 3 groups: group P 228 cases received only propofol(1-1.5 mg/kg) iv],group LEP 200 cases received lidocaine 20 mg and ephedrine 6 mg followed with propofol(1-1.5 mg/kg) iv] and group C as control 230 cases has endoscopy routinely and consciously with no anesthetic whatever].The BP,HR and SpO_2 were monitored at pre-,during and 5 min after endoscopy and the pain of injection,endoscopy time,awake time and satisfaction degree were recorded.RESULTS: As compared with those pre-endocsopy,the greatest changes of HR and BP in group P and C during endoscopy decreased by(20.0%-)30.0% or increased by 10.0%-30.0% respectively.The changes of HR and BP in group LEP were much lesser,with the BP decreasing by 3.0% and HR increasing by 7.0%.There was significant difference between group LEP and group P and C(P<0.05).The pain during administration of propofol was more severe in group P(185 cases,81.5%) than in group LEP(28 cases,14.0%)(P<(0.05)).CONCLUSION: Administration of propofol combined with a little dosage of lidocaine and ephedrine in advance is beneficial for gastrointestinal endoscopy.This method is safe and feasible for rapid onset of sedation with minimal cardiovascular responses.This method also reduces the pain of injection.