瑞芬太尼持续微泵输注复合小剂量异丙酚用于无痛肠镜的临床观察

目的观察瑞芬太尼持续微泵输注复合小剂量异丙酚用于无痛肠镜检查的麻醉效果和安全性。方法选取无痛肠镜检查患者150例,随机分为3组:瑞芬太尼组(R组)、瑞芬太尼十异丙酚组(RP组)、异丙酚组(P组),每组50例。R组给予瑞芬太尼1.5μg/kg持续静脉注射60 s,随后以0.1μg/(kg.min)持续微泵输注至退出肠镜时停药;RP组给予瑞芬太尼1.0μg/kg持续静脉注射60 s,随后以0.05μg/(kg.min)持续输注至开始退出肠镜时停药,在瑞芬太尼负荷剂量注完后同时静脉注射异丙酚1.0 mg/kg,术中必要时追加异丙酚0.5 mg/kg;P组单纯静脉注射异丙酚1.5 mg/kg持续60 s,术中必要时追加异丙酚0.5～1.0 mg/kg。结果 3组患者的麻醉效果均满意。RP组所用瑞芬太尼用量较R组明显减少(P<0.05),RP组异丙酚用量较P组明显减少(P<0.01)。术中在供氧状态下3组患者脉搏氧饱和度均≥98%。结论 瑞芬太尼用于无痛肠镜麻醉与异丙酚同样安全有效,复合小剂量异丙酚后不仅可显著提高麻醉效果,且可显著减少各自用量。

Clinical observation on persistent minipump infusion of remifentanil and small dose of propofol for indolent enteroscopy

Objective To observe the anesthetic effect and safty of persistent minipump infusion of remifentanil and small dose of propofol for indolent enteroscopy.Methods One hundred and fifty patients were randomly divided into 3 groups with 50 patients in each group.Patients in group R were given with remifentanil,patients in group RP were given with remifentanil and propofol,and patients in group P were given with propofol.Results All patients in each group were satisfactory to the anesthetic effect.The dosage of remifentanil in group RP was less than that of group R（P0.05）,while the dosage of propofol in group RP was strikingly less than that of group R（P0.01）.The SpO2 in patients of each group was over 98% under oxygen supply.Conclusion The application of remifentanil in indolent enteroscopy is effective and safe as propofol.The combination of remifentanil and propofol can increase the anesthetic effect and strikingly reduce the dosage of each drug.