依托咪酯复合小剂量舒芬太尼在老年人无痛肠镜检查中的应用

目的研究依托咪酯复合小剂量舒芬太尼静脉麻醉在老年人肠镜检查中的应用效果和心血管稳定性。方法选择ASAI～Ⅲ级老年无痛肠镜检查者80例,随机分成依托咪酯组(E组)和丙泊酚组(P组),每组40例。E组:静脉推注舒芬太尼0.1μg/kg,依托咪酯0.15～0.30mg/kg;P组:静脉推注舒芬太尼0.1μg/kg丙泊酚1.0～1.5mg/kg。监测并记录患者入室至检查结束不同时点的EKG、HR、SBP、DBP、SpO2、RR。观察两组苏醒时间、定向力恢复时间、镇痛评分及不良反应,并进行比较。结果E组和P组患者均顺利完成肠镜检查。P组在检查过程中血流动力学波动较明显,与诱导前比较差异有统计学意义(p<0.05);E组则变化较小,麻醉过程血流动力学保持平稳。两组患者入睡时间、苏醒时间、定向力恢复时间、镇痛评分比较差异无统计学意义(p>0.05)。结论依托咪酯复合小剂量舒芬太尼静脉麻醉应用于老年人肠镜检查效果良好,在心血管稳定性方面更优于丙泊酚。

APPLICATION OF ETOMIDATE COMBINED WITH SMALL DOSE SUFENTANIL FOR PAINLESS ENTEROSCOPY IN ELDERLY PATIENTS

Objective To investigate the effects of the application of etomidate combined with small dose sufentanil in total intravenous anesthesia for painless enteroscopy.Methods 80 ASA I or II patients（age range 62～75 yrs） who underwent enteroscopy under general anesthesia were enrolled in this study. These patients were randomly divided into 2 groups,40 patients in each group：Sufentanil with etomidate group （group E）; sufentanil with propofol group （group P）. The HR,SBP,DBP,SpO2,RR,VAS score and the time of recovery were observed and recorded in all patients. Results The enteroscopy was practiced successfully in patients of both groups nearly without any discomfort. Hemodynamics in group P was fluctuated dramatically, as compared with that in group E（p 〈0. 05）. Blood vessel irritation incidence in group P was significantly higher than group E（p 〈0.05）. Conclusion Application of etomidate combined with small sufentanil in painless enteroscopy is more effective and safer than propofol for elderly patients.