小剂量氯胺酮复合丙泊酚-芬太尼用于胃镜检查术

目的:探讨小剂量氯胺酮复合丙泊酚-芬太尼静脉麻醉在门诊胃镜检查术中应用的临床有效性和安全性.方法:将128例患者分为青壮年(A组 )和老年组(B组 ),对 A1,B1组(丙泊酚 芬太尼 ),A2,B2组(氯胺酮 0.1 mg/kg 丙泊酚 芬太尼 ),A3,B3组(氯胺酮 0.2 mg/kg 丙泊酚 芬太尼 ),分别观察胃镜检查过程中平均动脉压(MAP)、心率(HR)、氧分压(SPO2)、丙泊酚用量、苏醒时间、呼吸抑制发生率等指标.结果:所有患者诱导后 MAP,HR,SPO2均下降 ; A1,B1组较 A2,A3,B2,B3组下降更明显,呼吸抑制率明显增高,丙泊酚用量明显增加 ; B3,A3苏醒时间较 A1,A2,B1,B2组明显延长.结论:用 0.1 mg/kg氯胺酮复合丙泊酚-芬太尼静脉麻醉是无痛胃镜检查安全、有效的麻醉方式.

Small Dose of Ketamine Combined with Propofol- fentanyl in Gastroscopy

Objective:To explore effectiveness and safety of small dose of ketamine combined with propofol-fentanyl in intravenous anesthesia applied in outpatient gastroscopy.Methods:128 patients were divided into adult group (group A) and aged group (group B),subgroup A1,B1(propofol-fentanyl),subgroup A2,B2 (ketamine 0.1 mg/kg propofol-fentanyl),subgroup A3,B3 (ketamine 0.2 mg/kg propofol-fentanyl).MAP,HR,SPO2,dosage of propofol,wake up time,rate of respiratory depression were observed separately during gastroscopy.Results:After induction on all patients,MAP,HR,SPO2 went down.There were more significantly down of MAP,HR,SPO2 in A1,B1 than those in A2,A3,B2,B3 group.The rate of respiratory depression and dosage of propofol obviously increase in A1,B1 compared to these in A2,A3,B2,B3.Wake up time was longer obviously in B3,A3 than in A1,A2,B1,B2.Conclusion:Applying 0.1 mg/kg ketamine combined with propofol-fentanyl intravenous anesthesia in gastroscopy is an effective and safe method.