不同剂量依托咪酯复合丙泊酚在老年病人结肠镜检查中安全性及效果的比较

目的比较不同剂量依托咪酯复合丙泊酚在老年病人结肠镜检查中的安全性及效果。方法择期行结肠镜检查病人180例，采用随机数字表法分为3组:丙泊酚组（1.5 mg/kg，P组）、丙泊酚复合依托咪酯组（丙泊酚1.0 mg/kg+依托咪酯0.05 mg/kg，PE组）、依托咪酯复合丙泊酚组（丙泊酚0.75 mg/kg+依托咪酯0.075 mg/kg，EP组）。结肠镜检查前1 min所有病人静脉注射芬太尼1 μg/kg。P组静脉注射丙泊酚1.5 mg/kg。PE组静脉注射丙泊酚1.0 mg/kg复合依托咪酯0.05 mg/kg。EP组静脉注射丙泊酚0.75 mg/kg复合依托咪酯0.075 mg/kg。记录平均动脉压、心率、脉搏氧饱和度。记录麻醉时间、手术时间、苏醒时间、出院时间。记录病人不良反应及病人、内镜医生、麻醉医生满意度。结果与P组、PE组比较，EP组苏醒时间及出院时间更长（P < 0.05~P < 0.01）；与PE组、EP组比较，P组低血压、窦性心动过缓、低氧血症的发生率更高（P < 0.05~P < 0.01）；与P组比较，PE组与EP组病人对麻醉医生的满意度较高（P < 0.01）。结论丙泊酚1.0 mg/kg复合依托咪酯0.05 mg/kg用于老年病人结肠镜检查，病人苏醒时间及出院时间更短，不良反应更少。

Comparison of the safety and efficacy of different dosages of etomidate combined with propofol in colonoscopy of elderly patients

ObjectiveTo compare the safety and efficacy of different dosages of etomidate combined with propofol in colonoscopy of elderly patients.MethodsOne hundred and eighty patients scheduled by colonoscopy, were randomly divided into the propofol group(group P), propofol combined with etomidate group(group PE) and etomidate combined with propofol group(group EP).All patients were intravenously injected with 1 μg/kg fentanyl before 1 min of colonoscopy.The group P, group PE and group EP were injected with 1.5 mg/kg propofol, 1.0 mg/kg propofol combined with 0.05 mg/kg etomidate and 0.75 mg/kg propofol combined with 0.075 mg/kg etomidate, respectively.The mean aterial blood pressure, heart rate, saturation of peripheral oxygen, anesthesia duration, operation time, recovery time, discharge time, adverse reaction, and satisfaction degrees of patients, endoscopists and anesthetists in three groups were evaluated.ResultsCompared with the group P and group PE, the recovery time and discharge time in the group EP were significantly longer(P < 0.05 to P < 0.01).The incidence rates of hypotension, bradycardia and hypoxemia in the group P were significantly higher compared with the group PE and group EP(P < 0.05 to P < 0.01).The satisfaction degrees on anesthetists in the group PE and group EP were higher compared with the group P(P < 0.01).ConclusionsThe recovery time and discharge time in patients induced by 1.0 mg/kg propofol combined with 0.05 mg/kg etomida are shorter, and adverse reaction is less.