舒芬太尼联合丙泊酚在老年患者无痛胃镜检查中的应用

目的观察舒芬太尼联合丙泊酚在老年患者无痛胃镜检查中的效果及安全性。方法将120例ASA I～III级老年患者随机均分为丙泊酚组、芬太尼联合丙泊酚组、舒芬太尼联合丙泊酚组。丙泊酚组静脉给予丙泊酚,芬太尼联合丙泊酚组及舒芬太尼联合丙泊酚组先静脉给予芬太尼或舒芬太尼后给予丙泊酚。记录给药前（T1）、给药完毕（T2）、插入胃镜时（T3）、检查完毕（T4）、检查完毕后5m in（T5）及苏醒时（T6）的氧饱和度（SPO2）、平均动脉压（MAP）、脉搏（HR）、呼吸频率（RR）;并观察不良反应的发生情况。结果丙泊酚组及芬太尼联合丙泊酚组SPO2显著下降后又逐渐回升,芬太尼联合丙泊酚组T3～T6时点SPO2显著低于同时点的其它两组（P〈0.05）;丙泊酚组患者MAP在T2时点显著降低,而到T3时点又显著升高;丙泊酚组患者HR及RR在T3时点显著增加,芬太尼联合丙泊酚组RR在T4时点显著低于组内其他时点,且低于同时点的其他两组。丙泊酚组丙泊酚的用量及由于呛咳、体动反应明显需加药的病例数显著高于其他两组（P〈0.05）;芬太尼联合丙泊酚组患者SPO2降至70%需吸氧的患者数则要显著高于其他两组。结论舒芬太尼联合丙泊酚对老年患者进行无痛胃镜检查时既能达到满意的麻醉效果，又能保证患者的安全。

The Applications of Propofol Combined With Sufentanyl for Painless Gastrofiberscopy in Aged Patients

Objective To evaluate efficacy and safety of propofol combined with sufentanyl applied to anesthesia of painless gastrofiberscopy in aged patients. Methods One hundred and twenty ASA Ⅰ～Ⅲ patients were randomly and equally divided into three groups. Group P was given intravenous propofol, Group PF was given intravenous fentanyl and then propofol, and Group PS was given intravenous sufentanyl and then propofol. Gastrofiberscopy was inserted after eyelashes reflex had been extinct. The parameters, such as SPO2 , MAP, HR, RR , total dose of propofol, fentanyl, sufentanyl , the rate of adverse event, recovering time of consciousness , and awareness time during operation, were recorded on the following different points of time ： before takging medcine （ T1 ） , after takging medcine （ T2 ）, insertting gastrofiberscopy （ T3 ）, after checking up （ T4 ）, five minutes after checking up （ T5 ）, regaining consciousness （ T6 ）. Results SPO2 in the group of P and FP rised again after decreased remarkahlely. On T3 and T6 SPO2 of FP was much lower than in the other two groups （ P 〈 0.05 ）. MAP decreased significantly On T2 while rised conspicuously on T3 in the group of P （ P 〈 O. 05 ） ; HR and RR ascended to the top point on T3 in the group of P,while RR of Group FP dropped to the lowest point on T4 （P 〈0. 05 ） and was much lower than the other two groups on the same point. Total dose of propefol in Group P was significantly larger than that in Group PF and PS on account of the occurrence of cough and body - movement. The number of patients in FP who need to inhale oxygen when SPO2 dropped to 70% was much more than the two others. Conclusion The combination of propofol with sufentanyl applied to the operation of gastrofiberscopy in aged patients can provide satisfactory anesthesia effects and ensure the safety.