地佐辛复合丙泊酚麻醉在老年患者无痛胃镜术中的应用

目的评价地佐辛复合丙泊酚麻醉在老年患者无痛胃镜术中的应用效果。方法将行无痛胃镜术的147例老年患者随机分为地佐辛组(D组,n=51)、舒芬太尼组(S组,n=46)和对照组(C组,n=50)。D组患者静脉注射地佐辛20μg/kg,S组患者静脉注射舒芬太尼0.1μg/kg,C组患者静脉注射生理盐水;5 min后三组患者均注射丙泊酚1 mg/kg。分别于注药前(T1),睫毛反射消失时(T2)和定向力恢复时(T3)记录各组的平均动脉压(MAP)、心率(HR)、呼吸频率(RR)和脉搏氧饱和度(SpO2),并记录出现的不良事件、苏醒时间和丙泊酚用量。结果与T1时比较,T2时各组MAP均明显下降,D组下降缓和,与C组和S组的差异有统计学意义(P<0.05);C组和D组HR均明显下降,D组下降更明显,与C组差异有统计学意义(P<0.05);C组RR和SpO2明显下降,且SpO2较S组和D组明显下降(P<0.05)。S组和D组苏醒时间较C组明显缩短,丙泊酚用量明显减少(均P<0.05),且D组与S组差异也有统计学意义(P<0.05)。结论地佐辛应用于老年人无痛胃镜术,可明显减少丙泊酚用量,稳定循环呼吸功能,具有更好的安全性。

Application of dezocine combined with propofol in anesthesia for painless gastroscopy in elderly patients

Objective To evaluate the effectiveness of dezocine combined with propofol in anesthesia for painless gastroscopy in elderly patients.Methods One hundred and forty-seven elderly patients undergoing painless gastroscopy were randomly assigned to dezocine group(D group,n=51,infusion with dezocine 20 μg/kg + infusion with propoful 1 mg/kg 5 min later),sufentanil group(S group,n=46,infusion with sufentanil 0.1 μg/kg+ infusion with propoful 1 mg/kg 5 min later) and control group(C group,n=50,infusion with normal saline+ infusion with propoful 1 mg/kg 5 min later).The mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR) and pulse oxygen saturation(SpO2) were obtained before infusion(T1),after disappearance of eyelash reflex(T2) and after recovery of orientation(T3),and the adverse events,time for regaining consciousness and propofol dosage were also recorded.Results MAP at the time point of T2 was significantly lower than that at the time point of T1 in each group(P<0.05),and the decrease was alleviated in D group compared with C group and S group(P<0.05).HR was significantly decreased in C group and D group at the time point of T2,and the decrease in D group was more significant than that in C group(P<0.05).RR and SpO2 were significantly decreased in C group at the time point of T2,and SpO2 in C group was significantly lower than that in S group and D group at the time point of T2(P<0.05).Time for regaining consciousness and propofol dosage in S group and D group were significantly lower than those in C group(P<0.05),and there were significant differences between D group and S group(P<0.05).Conclusion The application of dezocine combined with propofol in anesthesia for painless gastroscopy in elderly patients may significantly reduce the dosage of propofol,stabilize the respiratory and circulatory function,and have favorable safety.