咪达唑仑联合异丙酚静脉麻醉在胃镜检查中的临床应用评估及对照研究

目的探讨咪达唑仑联合异丙酚静脉麻醉在胃镜检查中临床应用的安全性和价值。方法收集我院2007年10月-2008年10月门诊及住院患者,选择常规胃镜检查者226例为对照组,咪达唑仑联合异丙酚静脉麻醉辅助胃镜检查者72例为镇痛组,监测患者胃镜术前、术中收缩压（SBP）、舒张压（DBP）、心率（HR）、血氧饱和度（SpO2）的变化;观察并记录患者对胃镜插入时间、检查完成时间、耐受程度,是否有恶心、呛咳、躁动、呕吐等反应,术后患者完全清醒后询问其对胃镜检查的记忆缺失及感受,以及麻醉药物发生副作用的情况。结果镇痛组术中SBP、DBP、HR与术前比较有明显下降,差异有统计学意义（P〈0.05）;对照组术中SBP、DBP、HR与术前比较出现明显升高,差异有统计学意义（P〈0.05）,两组患者SpO2均无明显变化。镇痛组的平均胃镜插入时间较对照组短,差异有统计学意义（P〈0.05）;镇痛组的平均完成时间与对照组比较差异无统计学意义（P〉0.05）;镇痛组患者术中反应明显降低,感受明显好于对照组;患者术后对胃镜检查无痛苦回忆,满意度高,且并发症发生未增加;镇痛组胃镜检查成功率100%,对照组为96.9%,差异无统计学意义。两组患者均无意外情况发生。结论本组研究结果显示咪达唑仑联合异丙酚静脉麻醉用于胃镜检查镇静镇痛效果好,安全有效。但检查过程中应密切监测生命体征的变化。

Assessment and control study of midazolam united propofol intravenous anesthesia in clinical application of gastroscopy

Objective To discuss the safety and value of midazolam united propofol intravenous anesthesia in clinical application of gastroscopy.Methods Outpatients and inpatients in our hospital from October 2007 to October 2008 were collected.Two hundred and twenty-six cases of the conventional gastroscopy were selected as the control group,then 72 cases of midazolam united propofol intravenous anesthesia-assisted gastroscopy were selected as the analgesia group.The patients＇ changes of their systolic blood pressure（SBP）,diastolic blood pressure（DBP）,heart rate（HR） and oxygen saturation（SpO2） before and during the operation were monitored.The time of inserting the gastroscopy,completion time of gastroscopy,tolerance and whether the patients having other reactions,such as nausea,cough,restlessness,vomiting etc,were observed and recorded.After the operation,when the patients were fully conscious,the amnesia,feelings and drug side effects in gastroscopy were inquired.Results The intraoperative SBP,DBP and HR in the analgesia group significantly decreased compared with the preoperation（P〈0.05）.The intraoperative SBP,DBP and HR in the control group significantly increased compared with the preoperation（P〈0.05）.Two groups of patients had no significant changes in SpO2.The average time of inserting the gastroscopy was shorter in the analgesia group than that in the control group.There was no difference in completion time of gastroscopy between the analgesia group and the control group（P〉0.05）.Compared with the control group,intraoperative reaction in the analgesia group was significantly lower and patients＇ feelings were significantly better.The patients had no memories of pain to the gastroscopy in the analgesia group,so there was a high satisfaction and there was no increase in complications.The success rate of gastroscopy was 100% in analgesia group which was higher than that in the control group（96.9%）,but the difference was not significant.No accidents happened to all patients.Conclu